Organization
UC IRVINE HEALTH SPECIALTY CLINIC- TUSTIN
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 AND CHIEF EXECUTIVE)
(714) 456-2986
Entity
Organization
Contact information
Practice address
1451 IRVINE BLVD, TUSTIN, CA 92780-3804
(714) 838-8878
(714) 838-8988
Mailing address
PO BOX 515072, LOS ANGELES, CA 90051-5072
(714) 456-5717
(714) 456-7718
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/06/2015
Last updated
10/23/2015
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