MEMORIALCARE MEDICAL GROUP - MISSION VIEJO - CROWN VALLEY PARKWAY
NPI 1194866772
Non-Pharmacy Dispensing Site in Mission Viejo, CA
NPI Status: Active since February 08, 2007
Contact Information
26991 CROWN VALLEY PKWY
MISSION VIEJO, CA
ZIP 92691
Phone: (949) 582-2002
- Organization
- Non-Pharmacy Dispensing Site
- CLIA Number: 05D0580456
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-07-2027
About MEMORIALCARE MEDICAL GROUP - MISSION VIEJO - CROWN VALLEY PARKWAY
This page provides the complete NPI Profile along with additional information for Memorialcare Medical Group - Mission Viejo - Crown Valley Parkway, a provider established in Mission Viejo, California operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1194866772 assigned on February 2007. The practitioner's primary taxonomy code is 332900000X with license number A31048 (CA). The provider is registered as an organization and their NPI record was last updated 13 years ago. The provider's is doing business as Memorialcare Medical Group - Mission Viejo - Crown Valley Parkway. The authorized official of this NPI record is Mr. Kenny Heine (Vp Of Operations)
- NPI
- 1194866772
- Provider Legal Name
- MEMORIALCARE MEDICAL GROUP, INC.
- Other Organization Name
- MEMORIALCARE MEDICAL GROUP - MISSION VIEJO - CROWN VALLEY PARKWAY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 26991 CROWN VALLEY PKWY MISSION VIEJO, CA 92691
- Location Phone
- (949) 582-2002
- Mailing Address
- 5626 OBERLIN DR SUITE 110 SAN DIEGO, CA 92121
- Mailing Phone
- (858) 625-2990
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 02-08-2007
- Last Update Date
- 04-03-2013
- Code Navigator
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
Non-Pharmacy Dispensing Site
- Taxonomy Code
- 332900000X
- Type
- Suppliers
- License No.
- A31048
- License State
- CA
- Taxonomy Description
- 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.)
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
- 05D0580456
- Facility Type
- Physician Office
- Certificate Effective Date
- February 08, 2025
- Certificate Expiration Date
- February 07, 2027
- Laboratory Director
- GRACIA COVARRUBIAS, MD
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Memorialcare Medical Group - Mission Viejo - Crown Valley Parkway 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 1194866772, we treat the final digit (2) 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
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 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
MISSION VIEJO, CA 92691
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194866772, enumerated as an "organization" on February 08, 2007.
The provider is located at 26991 CROWN VALLEY PKWY MISSION VIEJO, CA 92691 and the phone number is (949) 582-2002.
Non-Pharmacy Dispensing Site with taxonomy code 332900000X.
