UC IRVINE HEALTH SPECIALTY CLINIC- TUSTIN
NPI 1457737678
Clinic/Center - Medical Specialty in Tustin, CA

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QM2500X and a focus in Medical Specialty.

Active since August 11, 2015CLIA 05D2086088 · Waiver

1451 IRVINE BLVD, TUSTIN, CA 92780(714) 838-8878(714) 838-8988 Get Directions Write a Review

NPPES record last updated: October 21, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Uc Irvine Health Specialty Clinic- Tustin NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UC IRVINE HEALTH SPECIALTY CLINIC- TUSTIN (NPI 1457737678) is a healthcare organization registered as a medical specialty in Tustin, California and active in the NPI registry since August 2015. The organization holds a CLIA Waiver certificate valid through October 27, 2026 and lists Manuel Porto, President And Ceo, as its authorized official.

NPPES Registry Identity

NPI1457737678

Entity TypeOrganization

Primary Taxonomy261QM2500X

Legal Business NameUC IRVINE HEALTH SPECIALTY CLINIC- TUSTIN

Location Address1451 IRVINE BLVDTustin, CA 92780-3804

Mailing AddressPo Box 54330Los Angeles, CA 90054-0330 · (714) 456-7783 · Fax (714) 456-7553

Phone(714) 838-8878

Fax(714) 838-8988

Organization SubpartYesParent: Regents Of The University Of California

Authorized OfficialManuel PortoPresident And Ceo · (714) 456-2986

Enumeration DateAugust 11, 2015

Last NPPES UpdateOctober 21, 2015

✔ NPI 1457737678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM2500X

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

1451 IRVINE BLVD, Tustin, CA 92780

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2086088

Uc Irvine Health Medical · Tustin, CA

Active · expires Oct 27, 2026

CLIA Number05D2086088

Laboratory TypePhysician Office

Certificate Effective DateOctober 28, 2024

Certificate Expiration DateOctober 27, 2026

Laboratory DirectorRoxann Engle, Do

Laboratory Phone(714) 838-8878

Laboratory LocationUc Irvine Health Medical1451 Irvine Blvd, Tustin, CA 92780

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID L SODARO M.D.

Family Medicine