Provider Demographics
NPI:1073783197
Name:IRVINE PEDIATRICS, INC
Entity Type:Organization
Organization Name:IRVINE PEDIATRICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:DOWNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-753-9000
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE 811
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3711
Mailing Address - Country:US
Mailing Address - Phone:949-753-9000
Mailing Address - Fax:949-753-5044
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE 811
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3711
Practice Address - Country:US
Practice Address - Phone:949-753-9000
Practice Address - Fax:949-753-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG 36655261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care