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General NPI Number Information
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NPI Number | 1518739309
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF CALIFORNIA IRVINE
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Dates
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Enumeration Date | 10/25/2023
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 19200 JAMBOREE ROAD SUITE 1500
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City | IRVINE
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State | CA
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Zip | 92612-2570
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Country | US
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Telephone | 714-456-7890
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 S DOUGLASS RD SUITE 200, ROUTE 183
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City | ANAHEIM
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State | CA
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Zip | 92806-6912
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REIMBURSEMENT DIRECTOR
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Name | GINA CHURCHILL
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Credential |
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Telephone | 916-240-3557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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