Provider Demographics
NPI:1629500665
Name:INTEGRITY HEALTHCARE PROVIDERS, PC
Entity Type:Organization
Organization Name:INTEGRITY HEALTHCARE PROVIDERS, PC
Other - Org Name:OC MEDICAL TUSTIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTALES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:714-442-6642
Mailing Address - Street 1:14642 NEWPORT AVE
Mailing Address - Street 2:SUITE 270
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6057
Mailing Address - Country:US
Mailing Address - Phone:714-442-6642
Mailing Address - Fax:714-442-6652
Practice Address - Street 1:14642 NEWPORT AVE
Practice Address - Street 2:SUITE 270
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6057
Practice Address - Country:US
Practice Address - Phone:714-442-6642
Practice Address - Fax:714-442-6652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty