Organization
PACE- UC IRVINE HEALTH, INTERNAL MEDICINE
Active
Parent organization
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Organization subpart
Yes
Provider details
NPI number
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Authorized official
DR. MANUEL PORTO M.D. (PRESIDENT)
(714) 456-2986
Entity
Organization
Contact information
Practice address
13300 GARDEN GROVE BLVD, GARDEN GROVE, CA 92843-2207
(714) 468-1100
(714) 468-1071
Mailing address
PO BOX 54509, LOS ANGELES, CA 90054-0509
(714) 456-6585
(714) 456-8101
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/30/2016
Last updated
03/30/2016
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