PACIFIC CDDC (NPI# 1861936601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861936601 |
| Entity Type | Organization |
| Organization Name | PACIFIC CDDC |
| Practice Address |
1640 Newport Blvd Suite 350 Costa Mesa CA 92627-3786 |
| Mailing Address |
Po Box 54708 Los Angeles CA 90054-0708 |
| Practice Telephone | 9493865260 |
| Practice Fax Number | 9495150031 |
| Mailing Telephone | 7144563856 |
| Mailing Fax Number | 7144568101 |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2016-12-13 |
| Authorized Official Name | DR. MANUEL PORTO (PRESIDENT) |
| Authorized Official Telephone | 7144562986 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | REGENT OF THE UNIVERSITY OF CALIFORNIA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952845794 | Pacific Cddc | Clinic/Center | 1640 Newport Blvd, Suite 350, Costa Mesa, CA 92627-3786 | 2016-12-13 |
| 1124402284 | Pacific Cddc | Clinic/Center | 1640 Newport Blvd, Suite 350, Costa Mesa, CA 92627-3786 | 2015-07-17 |
| Street Address |
1640 NEWPORT BLVD SUITE 350 |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92627-3786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437152998 | Swati R. Gandhi | Pediatrics | 1640 Newport Blvd, Costa Mesa, CA 92627-3786 | 2005-05-27 |
| 1134628704 | Scott Andrew Carlton | Chiropractor | 1640 Newport Blvd, Ste 440, Costa Mesa, CA 92627-3786 | 2018-02-08 |
| 1407392145 | Uc Irvine Cancer Center - Newport | Clinic/Center | 1640 Newport Blvd, Suite 450, Costa Mesa, CA 92627-3786 | 2017-01-18 |
| 1770027518 | Uc Irvine Health Cancer Center- Newport | Clinic/Center | 1640 Newport Blvd, Suite 450, Costa Mesa, CA 92627-3786 | 2016-12-13 |
| 1952845794 | Pacific Cddc | Clinic/Center | 1640 Newport Blvd, Suite 350, Costa Mesa, CA 92627-3786 | 2016-12-13 |
| 1043665615 | Trilogy Eye Medical Group, Inc. | Optometrist | 1640 Newport Blvd, 220, Costa Mesa, CA 92627-3786 | 2016-05-02 |
| 1942654439 | Uc Irvine Health Dermatology Services | Clinic/Center | 1640 Newport Blvd, Suite 240, Costa Mesa, CA 92627-3786 | 2016-04-20 |
| 1801257803 | Pacific Surgery Center | Clinic/Center | 1640 Newport Blvd, Suite 100, Costa Mesa, CA 92627-3786 | 2016-03-18 |
| 1124402284 | Pacific Cddc | Clinic/Center | 1640 Newport Blvd, Suite 350, Costa Mesa, CA 92627-3786 | 2015-07-17 |
| 1336521228 | Pacific Breast Care Center | Clinic/Center | 1640 Newport Blvd, Suite 200, Costa Mesa, CA 92627-3786 | 2015-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407174 | Ryan Allen Merrell | Technician | 313 E. 17th Pl #l Costa Mesa, Costa Mesa, CA 92627 | 2020-11-04 |
| 1245703412 | Allure Transportation | Non-emergency Medical Transport (VAN) | 1835 Newport Blvd Ste 109 #110, Costa Mesa, CA 92627 | 2019-01-09 |
| 1750857686 | Living Success Center | Marriage & Family Therapist | 445 E. 17th Street, Suites D & E, Costa Mesa, CA 92627 | 2018-10-18 |
| 1790298909 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 319-a University Drive, Costa Mesa, CA 92627 | 2017-11-09 |
| 1679086862 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 319-b University Drive, Costa Mesa, CA 92627 | 2017-11-09 |
| 1245759018 | Surgical Assistant Associates | Clinic/Center | 186 E. 16th Street, Suite C, Costa Mesa, CA 92627 | 2017-09-13 |
| 1366962334 | Guadalupe A. Mejia Dental Corp. | Dentist | 700 W 19th St., Suite C, Costa Mesa, CA 92627 | 2017-06-21 |
| 1386189033 | Jian Yi Ye | Acupuncturist | 2488 Newport Blvd Ste B1, Costa Mesa, CA 92627 | 2017-01-04 |
| 1144764606 | Michele Marie Patton | Dental Hygienist | 2220 Fairview Rd., Costa Mesa, CA 92627 | 2016-12-18 |
| 1881148500 | Valerie Nguyen | Pharmacist | 1835 Newport Blvd # C, Costa Mesa, CA 92627 | 2016-08-10 |
| Find all providers in zip 92627 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| 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). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164886495 | Kristin Pelinka, Md Inc. | Clinic/Center | 1190 Baker St Ste 103, Costa Mesa, CA 92626-4105 | 2016-04-12 |
| 1407392145 | Uc Irvine Cancer Center - Newport | Clinic/Center | 1640 Newport Blvd, Suite 450, Costa Mesa, CA 92627-3786 | 2017-01-18 |
| 1770027518 | Uc Irvine Health Cancer Center- Newport | Clinic/Center | 1640 Newport Blvd, Suite 450, Costa Mesa, CA 92627-3786 | 2016-12-13 |
| 1952845794 | Pacific Cddc | Clinic/Center | 1640 Newport Blvd, Suite 350, Costa Mesa, CA 92627-3786 | 2016-12-13 |
| 1942654439 | Uc Irvine Health Dermatology Services | Clinic/Center | 1640 Newport Blvd, Suite 240, Costa Mesa, CA 92627-3786 | 2016-04-20 |
| 1124402284 | Pacific Cddc | Clinic/Center | 1640 Newport Blvd, Suite 350, Costa Mesa, CA 92627-3786 | 2015-07-17 |
| 1518345255 | Uc Irvine Women's Health Care Center | Clinic/Center | 1640 Newport Blvd, Suite 340, Costa Mesa, CA 92627-3786 | 2015-05-14 |
| 1164800397 | Uc Irvine Women's Health Care Center | Clinic/Center | 1640 Newport Blvd, Suite 340, Costa Mesa, CA 92627-3786 | 2015-05-07 |
| 1073990495 | Orthopedic and Sports Medicine Center | Clinic/Center | 1640 Newport Blvd, Suite 230, Costa Mesa, CA 92627-3786 | 2015-05-05 |
| 1639560881 | Uc Irvine Health Pacific Coast Neurosurgery | Clinic/Center | 1640 Newport Blvd, Suite 240, Costa Mesa, CA 92627-3786 | 2015-02-10 |
| Find all providers in COSTA MESA | ||||
| City | COSTA MESA |
| Zip Code | 92627 |
Please comment or provide details below to improve the information on PACIFIC CDDC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.