Healthcare Provider Details

I. General information

NPI: 1710253604
Provider Name (Legal Business Name): DISCOVERY PRACTICE MANAGEMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2629 E CHAPMAN AVE STE A
ORANGE CA
92869-3206
US

IV. Provider business mailing address

18401 VON KARMAN AVE STE 500
IRVINE CA
92612-8531
US

V. Phone/Fax

Practice location:
  • Phone: 714-828-1800
  • Fax: 714-882-1186
Mailing address:
  • Phone: 714-828-1800
  • Fax: 714-882-1186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number980001602
License Number StateCA

VIII. Authorized Official

Name: MAGDALEN GUSTILO
Title or Position: AVP, PAYER RELATIONS & STRATEGY
Credential:
Phone: 714-568-7667