MEMORIALCARE MEDICAL GROUP, INC. (NPI# 1528100187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528100187 |
| Entity Type | Organization |
| Organization Name | MEMORIALCARE MEDICAL GROUP, INC. |
| Other Organization Name | MEMORIALCARE MEDICAL GROUP - SAN JUAN CAPISTRANO |
| Practice Address |
31001 Rancho Viejo Rd Suite 200 San Juan Capistrano CA 92675 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 9496619600 |
| Mailing Telephone | 8586252990 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2015-06-30 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | A38178 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| MemorialCare Medical Group - San Juan Capistrano | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558403444 | Memorialcare Medical Group, Inc. | Non-Pharmacy Dispensing Site | 23512 Madero, Mission Viejo, CA 92691-2743 | 2007-02-14 |
| 1215079298 | Memorialcare Medical Group, Inc. | Non-Pharmacy Dispensing Site | 4050 Barranca Pkwy, Suite 200, Irvine, CA 92604-7706 | 2007-02-13 |
| 1710029368 | Memorialcare Medical Group, Inc. | Non-Pharmacy Dispensing Site | 15 Mareblu, Suite 100, Aliso Viejo, CA 92656-3015 | 2007-02-12 |
| 1578605135 | Memorialcare Medical Group, Inc. | Non-Pharmacy Dispensing Site | 1212 W 17th St, Santa Ana, CA 92706-3418 | 2007-02-12 |
| 1912049578 | Memorialcare Medical Group, Inc. | Non-Pharmacy Dispensing Site | 29472 Avenida De Las Bandera, Rancho Santa Margarita, CA 92688-2651 | 2007-02-12 |
| 1346382033 | Memorialcare Medical Group, Inc. | Non-Pharmacy Dispensing Site | 3010 W Orange Ave, Suite 302, Anaheim, CA 92804-3169 | 2007-02-12 |
| 1194866772 | Memorialcare Medical Group, Inc. | Non-Pharmacy Dispensing Site | 26991 Crown Valley Pkwy, Mission Viejo, CA 92691-6528 | 2007-02-08 |
| Street Address |
31001 RANCHO VIEJO RD SUITE 200 |
| City | SAN JUAN CAPISTRANO |
| State | CA |
| Zip Code | 92675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588654123 | James H Ashizawa | Family Medicine | 31001 Rancho Viejo Rd, Suite 200, San Juan Capistrano, CA 92675 | 2005-10-25 |
| 1548526346 | David Gonzalez | Family Medicine | 31001 Rancho Viejo Rd, Suite 200, San Juan Capistrano, CA 92675 | 2012-04-05 |
| 1346341344 | Inchel Yeam | Internal Medicine | 31001 Rancho Viejo Rd, Suite 200, San Juan Capistrano, CA 92675-8704 | 2006-09-25 |
| 1801877170 | Trung Truong | Pediatrics | 31001 Rancho Viejo Rd, Suite 200, San Juan Capistrano, CA 92675 | 2005-11-14 |
| 1184605628 | Mimi Trinh | Family Medicine | 31001 Rancho Viejo Rd, Suite 200, San Juan Capistrano, CA 92675 | 2005-11-10 |
| 1427049071 | Scott Greenspan | Family Medicine | 31001 Rancho Viejo Rd, Suite 200, San Juan Capistrano, CA 92675 | 2005-11-02 |
| 1811988876 | George Karapetian | Family Medicine | 31001 Rancho Viejo Rd, Suite 200, San Juan Capistrano, CA 92675 | 2005-10-31 |
| 1881684405 | Craig P Albert | Family Medicine | 31001 Rancho Viejo Rd, Suite 200, San Juan Capistrano, CA 92675 | 2005-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184268088 | Dana Caballero | Social Worker | 30240 Racho Viejo Rd, Suite C-1, San Juan Capistrano, CA 92675 | 2019-11-04 |
| 1801363858 | Hgrt Medical Group Inc | Internal Medicine | 31741 Rancho Hill Viejo Road, San Juan Capistrano, CA 92675 | 2018-10-29 |
| 1487132551 | Alex James Vanderschelden | Chiropractor | 36461 Rancho Viejo Rd. Suiete 103, Suite 103, San Juan Capistrano, CA 92675 | 2018-08-01 |
| 1295224780 | Gateway Healthcare, Inc. | Skilled Nursing Facility | 29222 Rancho Viejo Rd Ste 127, San Juan Capistrano, CA 92675 | 2018-05-09 |
| 1033606991 | Pelican Point Dental | Dentist | 31103 Rancho Viejo Road Ste D2444, San Juan Capistrano, CA 92675 | 2018-04-17 |
| 1639677511 | Ocean Hills Recovery Inc. | Substance Abuse Rehabilitation Facility | 27126b Paseo Espada, Suite 725, San Juan Capistrano, CA 92675 | 2018-01-25 |
| 1679091441 | D Dawn Maxwell | Counselor | 30950 Rancho Viejo Rd Suite 225, San Juan Capistrano, CA 92675 | 2017-08-31 |
| 1417491523 | Terry D'amico | Physical Therapy Assistant | 32961 Calle Miguel, San Juan Capistrano, CA 92675 | 2016-12-08 |
| 1235580556 | Marriage Made Better Relationship Counseling | Community/Behavioral Health | 30200 Rancho Viejo Road, Suite D, San Juan Capistrano, CA 92675 | 2016-06-28 |
| 1679923288 | Shanti Recovery Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 31211 Casa Grande Drive, San Juan Capistrano, CA 92675 | 2016-06-14 |
| Find all providers in zip 92675 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023356730 | Trestles Pain Specialists, LLC | Non-Pharmacy Dispensing Site | 33171 Paseo Cerveza, 207, San Juan Capistrano, CA 92675-4870 | 2013-01-30 |
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| 1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
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| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
| Find all providers with the same taxonomy | ||||
| City | SAN JUAN CAPISTRANO |
| Zip Code | 92675 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.