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MEMORIAL FAMILY MEDICINE MEDICAL GROUP INC. NPI 1922329127


NPI Information

NPI: 1922329127
Provider Name: MEMORIAL FAMILY MEDICINE MEDICAL GROUP, INC.

Doing Business As: SAN CLEMENTE FAMILY MEDICINE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D2001769

Address:
450 E SPRING ST
SUITE 1
LONG BEACH, CA
ZIP 90806
Phone: (562) 933-0053
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MEMORIAL FAMILY MEDICINE MEDICAL GROUP, INC. is a family medicine in Long Beach, CA. The provider is 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. MEMORIAL FAMILY MEDICINE MEDICAL GROUP, INC. NPI is 1922329127. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As San Clemente Family Medicine.

The provider's business location address is:

450 E SPRING ST
SUITE 1
LONG BEACH, CA
ZIP 90806-625
Phone: (562) 933-0053
Fax: (562) 933-0079

The provider's authorized official is Susan Yvonne Melvin .
The authorized official title is President/ceo and has the following contact phone number (562) 933-0053.

The CLIA number assigned to this NPI record is 05D2001769 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/22/2010 and was last updated on 6/22/2010.


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
1207Q00000XFamily Medicine20A5075CALIFORNIAYes

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
1GR0071000MEDICAIDCALIFORNIA

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: 11/14/2023

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