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Organization

UNIVERSITY OF CALIFORNIA IRVINE

Active
Parent organization
UC IRVINE MEDICAL CENTER
Other names
UCI Family Health Center - Santa Ana
Organization subpart
Yes

Provider details

NPI number
Legal business name
UC IRVINE MEDICAL CENTER
Authorized official
GINA CHURCHILL (REIMBURSEMENT DIRECTOR)
(714) 509-6266
Entity
Organization

Contact information

Practice address
800 N MAIN ST, SANTA ANA, CA 92701
(714) 456-6785
Mailing address
1500 S DOUGLASS RD #200, RT 183, ANAHEIM, CA 92806-6912
(714) 509-6266

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
CA
261QI0500X
Infusion Therapy Clinic/Center
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
BCP11874F
CA
05
FHC11874F
CA
05
G9158701
CA
05
HAP11874F
CA
01
W1930
MEDICARE ID -TPE UNSPECIFIED
CA
Enumeration date
07/11/2006
Last updated
11/04/2019
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