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ST. MARTIN FAMILY MEDICAL CLINIC INC. NPI 1104044288


NPI Information

NPI: 1104044288
Provider Name: ST. MARTIN FAMILY MEDICAL CLINIC, INC.
Classification: Point of Service - 305S00000X
Entity Type: Organization
Address:
12555 GARDEN GROVE BLVD STE 506
GARDEN GROVE, CA
ZIP 92843
Phone: (714) 537-3900
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ST. MARTIN FAMILY MEDICAL CLINIC, INC. is a point of service in Garden Grove, CA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. ST. MARTIN FAMILY MEDICAL CLINIC, INC. NPI is 1104044288. The provider is registered as an organization entity type.

The provider's business location address is:

12555 GARDEN GROVE BLVD STE 506
GARDEN GROVE, CA
ZIP 92843-904
Phone: (714) 537-3900
Fax: (714) 537-7300

The provider's authorized official is Hung Nguyen .
The authorized official title is Direct Owner and has the following contact phone number (714) 537-3900.

The enumeration date for this NPI number is 4/23/2007 and was last updated on 11/21/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1305S00000XPoint of ServiceA61958CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W15494MEDICARE PINCALIFORNIA
200A061958MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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