MEMORIALCARE MEDICAL FOUNDATION (NPI# 1972910115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972910115 |
| Entity Type | Organization |
| Organization Name | MEMORIALCARE MEDICAL FOUNDATION |
| Other Organization Name | MEMORIALCARE MEDICAL GROUP FOUNTAIN VALLEY |
| Practice Address |
11420 Warner Ave Fountain Valley CA 92708-2529 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 7145491300 |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| 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 | 45197 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| MemorialCare Medical Group Fountain Valley | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932525433 | Memorialcare Medical Foundation | Non-Pharmacy Dispensing Site | 2110 N Bellflower Blvd, Long Beach, CA 90815-3126 | 2014-03-10 |
| 1770881666 | Memorialcare Medical Foundation | Internal Medicine | 23512 Madero, Mission Viejo, CA 92691-2743 | 2011-03-02 |
| 1376841254 | Memorialcare Medical Foundation | Internal Medicine | 11420 Warner Ave, Fountain Valley, CA 92708-2529 | 2011-03-02 |
| 1982901906 | Memorialcare Medical Foundation | Internal Medicine | 29472 Ave De Las Banderas, Rancho Santa Margarita, CA 92688-2651 | 2011-02-28 |
| 1295032985 | Memorialcare Medical Foundation | Internal Medicine | 250 E Yale Loop, Suite 200, Irvine, CA 92604-4697 | 2011-02-16 |
| 1427355122 | Memorialcare Medical Foundation | Internal Medicine | 30300 Rancho Viejo Rd, San Juan Capistrano, CA 92675-1576 | 2011-02-16 |
| 1912204611 | Memorialcare Medical Foundation | Physician Assistant | 26991 Crown Valley Pkwy, Mission Viejo, CA 92691-6528 | 2011-02-16 |
| 1316244015 | Memorialcare Medical Foundation | Physician Assistant | 1212 W 17th St, Santa Ana, CA 92706-3418 | 2011-02-16 |
| 1205131448 | Memorialcare Medical Foundation | Internal Medicine | 3010 W Orange Ave, #302, Anaheim, CA 92804-3169 | 2011-01-19 |
| 1043515281 | Memorialcare Medical Foundation | Pediatrics | 15 Mareblu, # 100, Aliso Viejo, CA 92656-3015 | 2011-01-19 |
| Street Address |
11420 WARNER AVE |
| City | FOUNTAIN VALLEY |
| State | CA |
| Zip Code | 92708-2529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205826849 | Arfa Babaknia | Family Medicine | 11420 Warner Ave, Fountain Valley, CA 92708-2529 | 2005-10-25 |
| 1265907984 | Carlie Dayle Galloway | Social Worker | 11420 Warner Ave, Fountain Valley, CA 92708-2529 | 2018-10-09 |
| 1578018396 | Christine Albrecht | Nurse Practitioner | 11420 Warner Ave, Fountain Valley, CA 92708-2529 | 2016-08-22 |
| 1104288562 | Leah Phan | Family Medicine | 11420 Warner Ave, Fountain Valley, CA 92708-2529 | 2016-03-24 |
| 1457731747 | Mahsa Rezaei | Family Medicine | 11420 Warner Ave, Fountain Valley, CA 92708-2529 | 2015-06-02 |
| 1730593666 | Julie Malhotra Balan | Family Medicine | 11420 Warner Ave, Fountain Valley, CA 92708-2529 | 2014-06-18 |
| 1558771188 | Sina Jalali Milani | Internal Medicine | 11420 Warner Ave, Fountain Valley, CA 92708-2529 | 2014-05-05 |
| 1376841254 | Memorialcare Medical Foundation | Internal Medicine | 11420 Warner Ave, Fountain Valley, CA 92708-2529 | 2011-03-02 |
| 1194044271 | Cindy H Lee | Nurse Practitioner | 11420 Warner Ave, Fountain Valley, CA 92708-2529 | 2010-05-27 |
| 1114253515 | Susan Jung Park | Family Medicine | 11420 Warner Ave, Fountain Valley, CA 92708-2529 | 2009-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932716222 | Changing Directions Psychological Corporation | Psychologist | 17280 Newhope Street, Suite 4, Fountain Valley, CA 92708 | 2020-09-30 |
| 1124632757 | Neck & Back Pain Specialists, A Balta Chiropractic Corporation | Chiropractor | 10231 Slater Ave. #113, Fountain Valley, CA 92708 | 2020-09-01 |
| 1295205425 | Alexander Nee Dds Inc | Dentist | 337 S Rancho Santa Fe Rd, San Marcos, CA 92708 | 2018-11-30 |
| 1093293052 | Claudia Raquel Santos | Physical Therapist | 18384 Brookhurst Street, Fountain Valley, CA 92708 | 2018-08-01 |
| 1659864338 | Orange County Respiratory Physicians Corp | Internal Medicine | 18111 Brookhurst St Ste 4600, Fountain Valley, CA 92708 | 2018-06-07 |
| 1992297881 | Ereny Abdelmalak Metry | Pharmacist | 9064 Daffodil Ave, Fountain Valley, CA 92708 | 2018-06-06 |
| 1144746348 | Goose Pharma, LLC | Pharmacy | 18049 Magnolia Street, Fountain Valley, CA 92708 | 2017-08-18 |
| 1932622347 | Mayra Alejandra Guerra | Social Worker | 18350 Mt Langley St, Suite 200, Fountain Valley, CA 92708 | 2017-07-18 |
| 1942722129 | Graph Surgery Inc | Plastic Surgery | 10760 Warner Ave, Ste 201, Fountain Valley, CA 92708 | 2017-07-10 |
| 1871022277 | Cathy A Castagna-petersen | Counselor | 10529 Slater Avenue, Fountain Valley, CA 92708 | 2017-06-08 |
| Find all providers in zip 92708 | ||||
| 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 |
|---|---|---|---|---|
| 1801146881 | Howard J. Marans, Md, Inc | Non-Pharmacy Dispensing Site | 11190 Warner Ave, Suite 306, Fountain Valley, CA 92708-4019 | 2012-09-17 |
| 1992074140 | Daniel Shin, Md, A Professional Corp | Non-Pharmacy Dispensing Site | 10956 Warner Ave, Fountain Valley, CA 92708-3853 | 2011-12-16 |
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|---|---|---|---|---|
| 1982225496 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 5757 Pacific Ave Ste 228, Stockton, CA 95207-5159 | 2020-05-06 |
| 1285268391 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 1337 S Lovers Ln Ste D, Visalia, CA 93292-5249 | 2020-02-27 |
| 1790327732 | Triumph Specialties LLC | Non-Pharmacy Dispensing Site | 11100 Sepulveda Blvd # 8-519, Mission Hills, CA 91345-1131 | 2019-10-10 |
| 1487210365 | Artius Dermatology Associates P.C. | Non-Pharmacy Dispensing Site | 325 Mall Dr Ste 111, Hanford, CA 93230-5950 | 2019-05-15 |
| 1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 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 | FOUNTAIN VALLEY |
| Zip Code | 92708 |
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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.