UC IRVINE HEALTH SPECIALTY CLINIC- TUSTIN (SURGERY) (NPI# 1366897860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366897860 |
| Entity Type | Organization |
| Organization Name | UC IRVINE HEALTH SPECIALTY CLINIC- TUSTIN (SURGERY) |
| Practice Address |
1451 Irvine Blvd Tustin CA 92780-3804 |
| Mailing Address |
Po Box 512347 Los Angeles CA 90051-0347 |
| Practice Telephone | 7148388408 |
| Practice Fax Number | 8778380003 |
| Mailing Telephone | 7144563856 |
| Mailing Fax Number | 7144566216 |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |
| Authorized Official Name | DR. MANUEL PORTO (PRESIDENT) |
| Authorized Official Telephone | 7144562986 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | REGENTS OF THE UNIVERSITY OF CALIFORNIA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
1451 IRVINE BLVD |
| City | TUSTIN |
| State | CA |
| Zip Code | 92780-3804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881649853 | Almoatazbellah Magdeldin Idriss | Internal Medicine | 1451 Irvine Blvd, Tustin, CA 92780-3804 | 2006-05-24 |
| 1285161968 | Shannon Melcher | Family Medicine | 1451 Irvine Blvd, Tustin, CA 92780-3804 | 2017-05-12 |
| 1447784590 | Maria Kim | Family Medicine | 1451 Irvine Blvd, Tustin, CA 92780-3804 | 2017-04-15 |
| 1558894907 | Thomas Azeizat | Family Medicine | 1451 Irvine Blvd, Tustin, CA 92780-3804 | 2017-04-04 |
| 1265887756 | Uc Irvine Health Specialty Clinic- Tustin (urology) | Clinic/Center | 1451 Irvine Blvd, Tustin, CA 92780-3804 | 2016-05-03 |
| 1467815241 | Uc Irvine Health Medical Group- Tustin, Fam Med | Clinic/Center | 1451 Irvine Blvd, Tustin, CA 92780-3804 | 2016-03-30 |
| 1447621826 | Uc Irvine Health Specialty Clinic - Tustin | Clinic/Center | 1451 Irvine Blvd, Tustin, CA 92780-3804 | 2015-10-12 |
| 1255707451 | University Head & Neck Surgeons | Clinic/Center | 1451 Irvine Blvd, Tustin, CA 92780-3804 | 2015-08-11 |
| 1457737678 | Uc Irvine Health Specialty Clinic- Tustin | Clinic/Center | 1451 Irvine Blvd, Tustin, CA 92780-3804 | 2015-08-11 |
| 1609252824 | Uc Irvine Health Medical Group- Tustin | Clinic/Center | 1451 Irvine Blvd, Tustin, CA 92780-3804 | 2015-08-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437780947 | John Michael Michael | Pharmacist | 14481 Wildeve Ln, Tustin, CA 92780 | 2020-02-03 |
| 1609426881 | Abigail Joy Maqsood | Behavior Technician | 290a S Prospect Ave, Tustin, CA 92780 | 2019-09-19 |
| 1255814711 | Hyun Dong Lee | Chiropractor | 14591 Newport Ave Ste 106, Tustin, CA 92780 | 2018-09-11 |
| 1346733573 | Elizabeth Kim Nguyen Dds Inc | Clinic/Center | 14521 Red Hill Ave, Tustin, CA 92780 | 2018-06-12 |
| 1255829503 | Hw Physical Therapy | Physical Therapist | 250 El Camino Real Ste 100, Tustin, CA 92780 | 2018-04-23 |
| 1912494352 | Gary Wayne Mcbeath | Marriage & Family Therapist | 17821 E 17th Street, Suite # 260, Tustin, CA 92780 | 2018-04-20 |
| 1104334598 | Catherine Bogues | Speech-Language Pathologist | 661 West 1st Street, Suite E, Tustin, CA 92780 | 2018-01-19 |
| 1972019941 | Lighthouse Behavioral Solutions | Behavioral Analyst | 18002 Irvine Blvd., Suite 202c, Tustin, CA 92780 | 2017-12-28 |
| 1629597299 | Lifecab, LLC | Non-emergency Medical Transport (VAN) | 13732 Newport Ave, Suite #1, Tustin, CA 92780 | 2017-09-14 |
| 1437606555 | Tustin Speech Therapy, Inc. | Speech-Language Pathologist | 661 West First Street, Suite E, Tustin, CA 92780 | 2016-09-07 |
| Find all providers in zip 92780 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972166452 | Ear Nose Throat Md Inc. | Clinic/Center | 2552 Walnut Ave Ste 130, Tustin, CA 92780-6970 | 2019-04-19 |
| 1053777912 | Lin Wu Dba Oc Health Acupuncture | Clinic/Center | 740 El Camino Real, Suite 100, Tustin, CA 92780-4369 | 2016-01-07 |
| 1386977296 | Garvin Group | Clinic/Center | 15455 Red Hill Ave Ste A, Tustin, CA 92780-7313 | 2009-09-09 |
| 1043453897 | Prospice Medical Centers | Clinic/Center | 14742 Newport Avenue, Suite 203, Tustin, CA 92780-6177 | 2009-04-09 |
| 1396916672 | Michael Oefelein, Md | Clinic/Center | 3302 Laviana St, Tustin, CA 92782-1926 | 2008-03-14 |
| 1295385573 | Orange County Community Acupuncture, Inc. | Clinic/Center | 202 Fashion Ln Ste 116, Tustin, CA 92780-3319 | 2019-09-18 |
| 1184277063 | Lam Md | Clinic/Center | 2492 Walnut Ave Ste 100, Tustin, CA 92780-6953 | 2019-07-19 |
| 1194122457 | Families Together of Orange County | Clinic/Center | 661 W 1st St, Ste. G, Tustin, CA 92780-2939 | 2014-12-01 |
| 1134394620 | Orthopaedic Medical Group of Santa Ana Inc | Clinic/Center | 18102 Irvine Boulevard, Suite 107, Tustin, CA 92780-3423 | 2008-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053272 | West Sacramento Primary Care Inc. | Clinic/Center | 2455 Jefferson Blvd Ste 100, West Sacramento, CA 95691-5329 | 2020-11-06 |
| 1306447941 | Bedford Breast Surgeons | Clinic/Center | 436 North Bedford Drive, Suite 105, Beverly Hills, CA 90210-4323 | 2020-11-02 |
| 1538767082 | County of Los Angeles | Clinic/Center | 6902 Atlantic Ave, Bell, CA 90201-3647 | 2020-10-15 |
| 1225636855 | Optimum Wellness and Weight Loss | Clinic/Center | 910 S El Camino Real Ste 100, San Clemente, CA 92672-4279 | 2020-10-15 |
| 1932707700 | Body By Design Wellness and Massage Clinic, Inc. | Clinic/Center | 3625 E Thousand Oaks Blvd Ste 215216, Westlake Village, CA 91362-3626 | 2020-10-14 |
| 1639786189 | Rams Ppe | Clinic/Center | 15329 Bonanza Rd Ste D, Victorville, CA 92392-2457 | 2020-09-29 |
| 1720695729 | Vila Facial Plastic Surgery | Clinic/Center | 1000 S Eliseo Dr Ste 203, Greenbrae, CA 94904-2151 | 2020-09-24 |
| 1902410442 | Hope Elementary School District | Clinic/Center | 3970 La Colina Rd Ste 14, Santa Barbara, CA 93110-1596 | 2020-09-02 |
| 1558974097 | Jiseki Health Inc | Clinic/Center | 1150 S King Rd Ste 40, San Jose, CA 95122-2140 | 2020-08-25 |
| 1902417678 | I-ma Acupuncture Inc | Clinic/Center | 2485 High School Ave Ste 123, Concord, CA 94520-1812 | 2020-08-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.