TUSTIN LONGEVITY CENTER NPI 1396999280

NPI Information

  • NPI: 1396999280
  • Provider Name: TUSTIN LONGEVITY CENTER
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 13422 NEWPORT AVE
    SUITE L
    TUSTIN, CA
    ZIP 92780
  • Phone: (714) 544-1521

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NPI Details

TUSTIN LONGEVITY CENTER is a family medicine in Tustin, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. TUSTIN LONGEVITY CENTER NPI is 1396999280. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

13422 NEWPORT AVE
SUITE L
TUSTIN, CA
ZIP 92780-746
Phone: (714) 544-1521
Fax: (714) 544-1904

The provider's authorized official is Elaine Daly .
The authorized official title is Office Manager and has the following contact phone number (714) 544-1521.

The enumeration date for this NPI number is 11/5/2008 and was last updated on 11/5/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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