TUSTIN IRVINE INTERNAL MEDICINE GROUP INC. NPI 1689633125

NPI Information

  • NPI: 1689633125
  • Provider Name: TUSTIN IRVINE INTERNAL MEDICINE GROUP INC.
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • CLIA Number: 05D0579825
  • Address: 17400 IRVINE BLVD
    SUITE F
    TUSTIN, CA
    ZIP 92780
  • Phone: (714) 838-5610

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NPI Details

TUSTIN IRVINE INTERNAL MEDICINE GROUP INC. is an internal medicine in Tustin, CA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. TUSTIN IRVINE INTERNAL MEDICINE GROUP INC. NPI is 1689633125. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

17400 IRVINE BLVD
SUITE F
TUSTIN, CA
ZIP 92780-030
Phone: (714) 838-5610
Fax: (714) 838-5931

The provider's authorized official is Mario S Ficarola .
The authorized official title is President and has the following contact phone number (714) 838-5610.

The CLIA number assigned to this NPI record is 05D0579825 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/22/2006 and was last updated on 6/10/2011.

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
1207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1A 22336MEDICARE UPINCALIFORNIA
2WA81987CMEDICARE PINCALIFORNIA
3WG14371AMEDICARE PINCALIFORNIA
4G58721MEDICARE UPINCALIFORNIA
5A 39242MEDICARE UPINCALIFORNIA
6W 1779MEDICARE PINCALIFORNIA
7YYY 42455 YOTHERCALIFORNIABLUE SHIELD
8WA61483DMEDICARE PINCALIFORNIA
9I 13910MEDICARE UPINCALIFORNIA
10A 47465MEDICARE UPINCALIFORNIA
11WG38399AMEDICARE PINCALIFORNIA
12WG56794AMEDICARE PINCALIFORNIA
13YYY 42455 YMEDICAIDCALIFORNIA
141962544494OTHERCALIFORNIANPI
15E 88030MEDICARE UPINCALIFORNIA
16I 59444MEDICARE UPINCALIFORNIA
17WA91056AMEDICARE PINCALIFORNIA

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: 3/30/2025

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