UC IRVINE HEALTH MEDICAL GROUP- TUSTIN, FAM MED
NPI 1467815241
Clinic/Center - Multi-Specialty in Tustin, CA

Q: What is Uc Irvine Health Medical Group- Tustin, Fam Med's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Active since March 30, 2016CLIA 05D2086088 · Waiver

1451 IRVINE BLVD, TUSTIN, CA 92780(714) 456-7002(949) 824-2828 Get Directions Write a Review

NPPES record last updated: March 30, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Uc Irvine Health Medical Group- Tustin, Fam Med NPPES

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

UC IRVINE HEALTH MEDICAL GROUP- TUSTIN, FAM MED (NPI 1467815241) is a healthcare organization registered as a multi-specialty in Tustin, California and active in the NPI registry since March 2016. The organization holds a CLIA Waiver certificate valid through October 27, 2026 and lists Manuel Porto, President, as its authorized official.

NPPES Registry Identity

NPI1467815241

Entity TypeOrganization

Primary Taxonomy261QM1300X

Legal Business NameUC IRVINE HEALTH MEDICAL GROUP- TUSTIN, FAM MED

Location Address1451 IRVINE BLVDTustin, CA 92780-3804

Mailing AddressPo Box 513620Los Angeles, CA 90051-3620 · (714) 456-6585 · Fax (714) 456-8101

Phone(714) 456-7002

Fax(949) 824-2828

Organization SubpartYesParent: Regents Of The University Of California

Authorized OfficialManuel PortoPresident · (714) 456-2986

Enumeration DateMarch 30, 2016

✔ NPI 1467815241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM1300X

1451 IRVINE BLVD, Tustin, CA 92780

Open in Google Maps ↗

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 Name

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.

RENEE HEATHER BALLENTINE DO

Family Medicine