Tustin Irvine Internal Medicine Group Inc.
LBN: Tustin Irvine Internal Medicine Group Inc.
Tustin Irvine Internal Medicine Group Inc. is an health care organization with primary practice located at 17400 Irvine Blvd Suite F, Tustin CA 92780-3030. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty.
Tustin Irvine Internal Medicine Group Inc. can be contacted via phone (714) 838-5610, or through Ficarola, Mario S via phone (714) 838-5610.
Contact Information
Primary practice address
17400 Irvine Blvd Suite F
Tustin CA 92780-3030
Phone: (714) 838-5610
Fax: (714) 838-5931
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X |
Profile Details
| NPI number | 1689633125 |
|---|---|
| LBN Legal business name | Tustin Irvine Internal Medicine Group Inc. |
| DBA Doing business as | |
| Authorized official | Ficarola, Mario S Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 22nd, 2006 |
| Last updated | Jun 10th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689633125 | NPPES |
| California | Other | YYY 42455 Y | BLUE SHIELD |
| California | Other | 1962544494 | BLUE SHIELD |
| California | MEDICAID | YYY 42455 Y | BLUE SHIELD |
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