MEMORIALCARE MEDICAL GROUP, INC. (NPI# 1558403444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558403444 |
| Entity Type | Organization |
| Organization Name | MEMORIALCARE MEDICAL GROUP, INC. |
| Other Organization Name | MEMORIALCARE MEDICAL GROUP - MADERO |
| Practice Address |
23512 Madero Mission Viejo CA 92691-2743 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 9495831600 |
| Mailing Telephone | 8586252990 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2013-04-03 |
| 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 | A63616 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| MemorialCare Medical Group - Madero | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1528100187 | Memorialcare Medical Group, Inc. | Non-Pharmacy Dispensing Site | 31001 Rancho Viejo Rd, Suite 200, San Juan Capistrano, CA 92675 | 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 |
23512 MADERO |
| City | MISSION VIEJO |
| State | CA |
| Zip Code | 92691-2743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417948621 | Scott S Lee | Family Medicine | 23512 Madero, Mission Viejo, CA 92691-2743 | 2005-11-04 |
| 1376055749 | Regina Mariano Baldo | Nurse Practitioner | 23512 Madero, Mission Viejo, CA 92691-2743 | 2017-10-25 |
| 1770881666 | Memorialcare Medical Foundation | Internal Medicine | 23512 Madero, Mission Viejo, CA 92691-2743 | 2011-03-02 |
| 1962712729 | Nishchal Kumar | Family Medicine | 23512 Madero, Mission Viejo, CA 92691-2743 | 2010-10-14 |
| 1194043448 | Maria Felicia Hidalgo Marcos | Nurse Practitioner | 23512 Madero, Mission Viejo, CA 92691-2743 | 2010-05-12 |
| 1952557951 | Ziba Ranjbaran | Physical Medicine & Rehabilitation | 23512 Madero, Mission Viejo, CA 92691-2743 | 2008-08-11 |
| 1568624948 | Jasbir Kaur | Family Medicine | 23512 Madero, Mission Viejo, CA 92691-2743 | 2008-06-27 |
| 1275707598 | Uyen Dang | Family Medicine | 23512 Madero, Memorialcare Medical Group, Mission Viejo, CA 92691-2743 | 2008-04-17 |
| 1447448873 | Marjan Amaneh Pedarsani | Family Medicine | 23512 Madero, Mission Viejo, CA 92691-2743 | 2007-10-10 |
| 1306927371 | Arnold Cuenca | Family Medicine | 23512 Madero, Mission Viejo, CA 92691 | 2006-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748247 | Sonja Wood | Registered Nurse | 92691 Avenida Deseo, Mission Viejo, CA 92691 | 2020-04-09 |
| 1912488487 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 27551 Puerta Real, Mission Viejo, CA 92691 | 2018-08-23 |
| 1518457704 | Leon Baginski Md Inc | Obstetrics & Gynecology | 26800 Crown Valley Pkwy Ste 560, Mission Viejo, CA 92691 | 2018-05-14 |
| 1215426762 | Gail G Warner | Marriage & Family Therapist | 26050 Acero, Suite 301, Mission Viejo, CA 92691 | 2018-05-09 |
| 1508354176 | Tania Choudhary | Student in an Organized Health Care Education/Training Program | 23595 Rangoon St, Mission Viejo, CA 92691 | 2018-04-28 |
| 1710486519 | Aubriana Denise Gray | Counselor | 25802 Pacifica Ave, Mission Viejo, CA 92691 | 2018-02-07 |
| 1487162707 | Alberto Israel Galicia | Case Manager/Care Coordinator | 27261 Las Ramblas, Suite 220, Mission Viejo, CA 92691 | 2018-01-22 |
| 1629595244 | Elisabeth A Lischer | Counselor | 26137 La Paz Road, Suite 230, Mission Viejo, CA 92691 | 2017-08-24 |
| 1639694227 | Dr. Horiyat, A Dental Corporation | Dentist | 27652 Crown Valley Parkway, Mission Viejo, CA 92691 | 2017-08-04 |
| 1255851689 | Jackelin Liseth Martinez | Counselor | 25402 Pacifica Avenue, Mission Viejo, CA 92691 | 2017-06-27 |
| Find all providers in zip 92691 | ||||
| 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 |
|---|---|---|---|---|
| 1942511407 | Southland Family & Urgent Care Inc | Non-Pharmacy Dispensing Site | 27660 Santa Margarita Pkwy, Mission Viejo, CA 92691-6674 | 2010-06-29 |
| 1194866772 | Memorialcare Medical Group, Inc. | Non-Pharmacy Dispensing Site | 26991 Crown Valley Pkwy, Mission Viejo, CA 92691-6528 | 2007-02-08 |
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| 1043719206 | Southern California Orthopedic Institute L.p | Non-Pharmacy Dispensing Site | 4100 Empire Dr Ste 120, Bakersfield, CA 93309-0408 | 2018-02-02 |
| 1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
| 1215462080 | Mas Management Group, Inc. | Non-Pharmacy Dispensing Site | 28446 Constellation Rd, Valencia, CA 91355-5081 | 2017-04-28 |
| 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 | MISSION VIEJO |
| Zip Code | 92691 |
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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.