Provider Demographics
NPI:1669660817
Name:SPH IRVINE, L.L.C.
Entity Type:Organization
Organization Name:SPH IRVINE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-705-5105
Mailing Address - Street 1:20360 SW BIRCH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1532
Mailing Address - Country:US
Mailing Address - Phone:949-833-1432
Mailing Address - Fax:
Practice Address - Street 1:20360 SW BIRCH ST STE 110
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1532
Practice Address - Country:US
Practice Address - Phone:949-833-1432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000281261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051188Medicare PIN