Provider Demographics
NPI:1558504639
Name:UNIVERSITY OF CALIFORNIA AT IRVINE MEDICAL CENTER
Entity type:Organization
Organization Name:UNIVERSITY OF CALIFORNIA AT IRVINE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:RATSIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-456-6661
Mailing Address - Street 1:5152 DUNBAR AVE
Mailing Address - Street 2:APT.A
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-5186
Mailing Address - Country:US
Mailing Address - Phone:714-390-7578
Mailing Address - Fax:714-840-7886
Practice Address - Street 1:101 THE CITY DR S
Practice Address - Street 2:# 56
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3201
Practice Address - Country:US
Practice Address - Phone:714-456-7890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102456282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital