BRISTOL PARK MEDICAL GROUP, INC. (NPI# 1609823251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609823251 |
| Entity Type | Organization |
| Organization Name | BRISTOL PARK MEDICAL GROUP, INC. |
| Practice Address |
30300 Rancho Viejo Rd San Juan Capistrano CA 92675-1576 |
| Mailing Address |
2742 Dow Ave Tustin CA 92780-7242 |
| Practice Telephone | 9496619600 |
| Practice Fax Number | 9494436200 |
| Mailing Telephone | 7146651600 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2008-10-15 |
| Authorized Official Name | MR. MARK D SCHAFER (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7146651661 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0069190 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740237460 | Bristol Park Medical Group, Inc. | Family Medicine | 16300 Sand Canyon Ave, 4th Floor, Irvine, CA 92618-3711 | 2006-05-28 |
| 1275580995 | Bristol Park Medical Group, Inc. | Internal Medicine | 1212 W 17th St, Santa Ana, CA 92706-3418 | 2006-05-28 |
| 1528015278 | Bristol Park Medical Group, Inc. | Internal Medicine | 23512 Madero, Mission Viejo, CA 92691-2743 | 2006-05-28 |
| 1861449514 | Bristol Park Medical Group, Inc. | Internal Medicine | 29472 Avenida De Las Bandera, Rancho Santa Margarita, CA 92688-2651 | 2006-05-28 |
| Street Address |
30300 RANCHO VIEJO RD |
| City | SAN JUAN CAPISTRANO |
| State | CA |
| Zip Code | 92675-1576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790776805 | Richard B Hernandez | Family Medicine | 30300 Rancho Viejo Rd, San Juan Capistrano, CA 92675-1576 | 2005-10-31 |
| 1932591484 | A Better Life Recovery LLC | Clinic/Center | 30300 Rancho Viejo Rd, San Juan Capistrano, CA 92675-1576 | 2015-02-20 |
| 1427355122 | Memorialcare Medical Foundation | Internal Medicine | 30300 Rancho Viejo Rd, San Juan Capistrano, CA 92675-1576 | 2011-02-16 |
| 1275519845 | Jeff Angarola | Surgery | 30300 Rancho Viejo Rd, San Juan Capistrano, CA 92675-1576 | 2005-12-15 |
| 1104808161 | Eric J Wong | Pediatrics | 30300 Rancho Viejo Rd, San Juan Capistrano, CA 92675-1576 | 2005-11-16 |
| 1003807488 | Maricel V Sabado | Family Medicine | 30300 Rancho Viejo Rd, San Juan Capistrano, CA 92675-1576 | 2005-11-03 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942696133 | Mark Stephen Sutton, Md Amc | Family Medicine | 30200 Rancho Viejo Rd, San Juan Capistrano, CA 92675-1560 | 2015-04-14 |
| 1609931401 | Don Ray Mccanne | Family Medicine | 33781 Avenida Calita, San Juan Capistrano, CA 92675-4905 | 2006-12-22 |
| 1174536726 | Olina Ellen Harwer | Family Medicine | 32241 Camino Capistrano Ste A105, San Juan Capistrano, CA 92675-3708 | 2006-08-14 |
| 1699755264 | K Mitchell Naficy | Family Medicine | 27512 Calle Arroyo Ste A, San Juan Capistrano, CA 92675-6783 | 2006-01-19 |
| 1790776805 | Richard B Hernandez | Family Medicine | 30300 Rancho Viejo Rd, San Juan Capistrano, CA 92675-1576 | 2005-10-31 |
| 1700877842 | Andrew J Hong | Family Medicine | 31001 Rancho Viejo Rd., Suite 200, San Juan Capistrano, CA 92675-8703 | 2005-10-28 |
| 1588654123 | James H Ashizawa | Family Medicine | 31001 Rancho Viejo Rd, Suite 200, San Juan Capistrano, CA 92675 | 2005-10-25 |
| 1699262873 | Olina E. Harwer, M.d., Inc. | Family Medicine | 32241 Camino Capistrano Ste A105, San Juan Capistrano, CA 92675-3708 | 2018-04-13 |
| 1033501077 | Pacific Private Practice Network Inc | Family Medicine | 30230 Rancho Viejo Rd, Suite 110, San Juan Capistrano, CA 92675-1557 | 2015-02-27 |
| 1376980169 | Robert R. Paredes, M.d. Inc. | Family Medicine | 31411 Camino Capistrano, Suite 100, San Juan Capistrano, CA 92675-2660 | 2013-06-03 |
| Find all providers in SAN JUAN CAPISTRANO | ||||
| City | SAN JUAN CAPISTRANO |
| Zip Code | 92675 |
Please comment or provide details below to improve the information on BRISTOL PARK MEDICAL GROUP, INC..
| 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.