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SPECIALTY MEDICAL CENTER, INC
NPI 1104933183
Internal Medicine - Nephrology in Fullerton, CA

Active since August 24, 2006CLIA 05D0985397 · Microscopy
1401 S BROOKHURST RD, SUIT 100, FULLERTON, CA 92833(714) 626-0700(714) 626-0800 Get Directions Write a Review

NPPES record last updated: January 14, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Specialty Medical Center, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPECIALTY MEDICAL CENTER, INC (NPI 1104933183) is a healthcare organization registered as a nephrology in Fullerton, California and active in the NPI registry since August 2006. The organization holds a CLIA Microscopy certificate valid through April 16, 2027 and lists Mark Myungjae Song, Physician/sole Owner, as its authorized official.

NPPES Registry Identity

NPI1104933183
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameSPECIALTY MEDICAL CENTER, INC
Location Address1401 S BROOKHURST RD, SUIT 100Fullerton, CA 92833
Mailing Address1401 S Brookhurst Rd, Suit 100Fullerton, CA 92833 · (714) 626-0700 · Fax (714) 626-0800
Phone(714) 626-0700
Fax(714) 626-0800
Organization SubpartNo
Authorized OfficialMark Myungjae SongPhysician/sole Owner · (701) 626-0700
Enumeration DateAugust 24, 2006
Last NPPES UpdateJanuary 14, 2011
✔ NPI 1104933183 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in CA · A49785
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
1401 S BROOKHURST RD, Fullerton, CA 92833
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Other Identifiers 3

Medicaid00A497850CA
Medicare UPING68608
Medicare ID-Type UnspecifiedA49785

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0985397

Specialty Medical Center, Inc · Fullerton, CA
Active · expires Apr 16, 2027
CLIA Number05D0985397
Laboratory TypePhysician Office
Certificate Effective DateApril 17, 2025
Certificate Expiration DateApril 16, 2027
Laboratory DirectorMark M. Song MD
Laboratory Phone(714) 626-0700
Laboratory LocationSpecialty Medical Center, Inc1401 South Brookhurst Road Suite 100, Fullerton, CA 92833
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FULLERTON MEDICAL PHARMACY INC
Pharmacy (Community/Retail Pharmacy)
1401 S BROOKHURST RD, STE 101
FULLERTON, CA 92833
Orange County (714) 992-4908
BOM SEOK JEON
Dentist (Oral and Maxillofacial Surgery)
1401 S BROOKHURST RD, STE 104
FULLERTON, CA 92833
Orange County (714) 879-2828
PAUL CHOONG HWAN LEE MD A MEDICAL CORPORATION
Ophthalmology
1401 S BROOKHURST RD, SUITE 105
FULLERTON, CA 92833
Orange County (714) 539-3232
RICHARD SOUNG BIEN P.T.,L.AC., PH.D.
Physical Therapist
1401 S BROOKHURST RD, SUITE 105
FULLERTON, CA 92833
Orange County (714) 446-0708
JOHN C. KANG, MD, A PROFESSIONAL CORPORATION
Surgery
1401 S BROOKHURST RD, SUITE 111
FULLERTON, CA 92833
Orange County (714) 626-0301
JOY HYUNAE KIM DC
Chiropractor
1401 S BROOKHURST RD, STE 103
FULLERTON, CA 92833
Orange County (714) 449-9700
ESTHER KYUNG-J YU PHARMD
Pharmacist
1401 S BROOKHURST RD
FULLERTON, CA 92833
Orange County (714) 992-4908
BIO-MEDICAL APPLICATIONS OF CALIFORNIA INC.
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
1401 S BROOKHURST RD
FULLERTON, CA 92833
Orange County (714) 773-1407

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Specialty Medical Center, Inc's NPI number?

The NPI number for Specialty Medical Center, Inc is 1104933183. It was assigned to this organization in the NPPES registry on August 24, 2006.

Where is Specialty Medical Center, Inc located?

Specialty Medical Center, Inc is located at 1401 S Brookhurst Rd Suit 100, Fullerton, CA 92833. The listed phone number is (714) 626-0700.

What is Specialty Medical Center, Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Does Specialty Medical Center, Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0985397) is associated with this NPI, valid through April 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Specialty Medical Center, Inc was last updated on January 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.