NPI 1104013879 · live from the CMS NPI Registry
Minuteclinic Diagnostic Medical Group Of Orange County INC
Nurse Practitioner in Irvine, CA. National Provider Identifier 1104013879, active.
NPI record
| NPI | 1104013879 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 14330 Culver Dr, Irvine, CA 92604 |
| Practice phone | 866-389-2727 |
| Mailing address | Po Box 772, Minuteclinic Credentialing, Woonsocket, RI 02895 |
| Enumerated | September 26, 2007 |
| Last updated | October 11, 2024 |
| Authorized official | Deborah Pincince, Administrator |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Professional | 101YP2500X | — |
| Social Worker, Clinical | 1041C0700X | — |
| Marriage & Family Therapist | 106H00000X | — |
| Nurse Practitioner primary | 363L00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.