SPECIALTY MEDICAL CENTER, INC
NPI 1104933183
Internal Medicine - Nephrology in Fullerton, CA
NPI Status: Active since August 24, 2006
Contact Information
1401 S BROOKHURST RD
SUIT 100
FULLERTON, CA
ZIP 92833
Phone: (714) 626-0700
Fax: (714) 626-0800
- Organization
- Internal Medicine
- Nephrology
- CLIA Number: 05D0985397
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-16-2027
About SPECIALTY MEDICAL CENTER, INC
This page provides the complete NPI Profile along with additional information for Specialty Medical Center, Inc, an internist established in Fullerton, California operating as a Internal Medicine, focusing in nephrology . The healthcare provider is registered in the NPI registry with number 1104933183 assigned on August 2006. The practitioner's primary taxonomy code is 207RN0300X with license number A49785 (CA). The provider is registered as an organization and their NPI record was last updated 15 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mr. Mark Myungjae Song Md (Physician/sole Owner)
- NPI
- 1104933183
- Provider Name
- SPECIALTY MEDICAL CENTER, INC
- Entity Type
- Organization
- Location Address
- 1401 S BROOKHURST RD SUIT 100 FULLERTON, CA 92833
- Location Phone
- (714) 626-0700
- Location Fax
- (714) 626-0800
- Mailing Address
- 1401 S BROOKHURST RD SUIT 100 FULLERTON, CA 92833
- Mailing Phone
- (714) 626-0700
- Mailing Fax
- (714) 626-0800
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-24-2006
- Last Update Date
- 01-14-2011
- Code Navigator
An internist like Specialty Medical Center, Inc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Nephrology
- Taxonomy Code
- 207RN0300X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- A49785
- License State
- CA
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00A497850 | MEDICAID (05) | CA | |
| G68608 | MEDICARE UPIN (02) | ||
| A49785 | MEDICARE ID-TYPE UNSPECIFIED (04) |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0985397
- Facility Type
- Physician Office
- Certificate Effective Date
- April 17, 2025
- Certificate Expiration Date
- April 16, 2027
- Laboratory Director
- MARK M. SONG MD
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Specialty Medical Center, Inc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104933183, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 9 providers are registered at the same or a nearby location.
FULLERTON, CA 92833
FULLERTON, CA 92833
FULLERTON, CA 92833
FULLERTON, CA 92833
FULLERTON, CA 92833
FULLERTON, CA 92833
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104933183, enumerated as an "organization" on August 24, 2006.
The provider is located at 1401 S BROOKHURST RD SUIT 100 FULLERTON, CA 92833 and the phone number is (714) 626-0700.
Internal Medicine with taxonomy code 207RN0300X and a focus in Nephrology.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
