1669668232 NPI number — REGENTS OF THE UNIVERSITY OF CALIFORNIA-IRVINE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669668232 NPI number — REGENTS OF THE UNIVERSITY OF CALIFORNIA-IRVINE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGENTS OF THE UNIVERSITY OF CALIFORNIA-IRVINE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
IRVINE CORP HEALTH SERVICES
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669668232
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/18/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 S MANCHESTER AVE STE 315
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORANGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92868-3213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-456-2986
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GOTTSCHALK MEDICAL PLAZA
Provider Second Line Business Practice Location Address:
ONE MEDICAL PLAZA DRIVE
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92697-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-456-2986
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ROPES
Authorized Official First Name:
LOUISE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
ADMINISTRATIVE ANALYST
Authorized Official Telephone Number:
714-456-2986

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  G64364 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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