MEMORIALCARE MEDICAL GROUP - ALISO VIEJO
NPI 1710029368
Non-Pharmacy Dispensing Site in Aliso Viejo, CA

NPI Status: Active since February 12, 2007

Contact Information

15 MAREBLU
SUITE 100
ALISO VIEJO, CA
ZIP 92656
Phone: (949) 448-0656

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  • Organization
  • Non-Pharmacy Dispensing Site
  • CLIA Number: 05D0581012
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-07-2027

About MEMORIALCARE MEDICAL GROUP - ALISO VIEJO

This page provides the complete NPI Profile along with additional information for Memorialcare Medical Group - Aliso Viejo, a provider established in Aliso Viejo, California operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1710029368 assigned on February 2007. The practitioner's primary taxonomy code is 332900000X with license number A43924 (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 - Aliso Viejo. The authorized official of this NPI record is Kenny Heine (Vp Of Operations)

NPI
1710029368
Provider Legal Name
MEMORIALCARE MEDICAL GROUP, INC.
Other Organization Name
MEMORIALCARE MEDICAL GROUP - ALISO VIEJO
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
15 MAREBLU SUITE 100 ALISO VIEJO, CA 92656
Location Phone
(949) 448-0656
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
02-12-2007
Last Update Date
04-03-2013
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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.
A43924
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.)

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KENNY HEINE

Authorized Official Title
VP OF OPERATIONS
Authorized Official Phone
(858) 625-2990

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
05D0581012
Facility Type
Physician Office
Certificate Effective Date
February 08, 2025
Certificate Expiration Date
February 07, 2027
Laboratory Director
STEPHEN HARMS
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Memorialcare Medical Group - Aliso Viejo 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 1710029368, we treat the final digit (8) 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 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).

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.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
1
Doubled → 2
Pos 4
0
Unchanged
Pos 5
0
Doubled → 0
Pos 6
2
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
3
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
8
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 1 → 2 0 → 0 9 → 18 → 9 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 2 + 0 + 0 + 2 + 1 + 8 + 3 + 1 + 2 + 24 = 52

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 52 is 60. The difference is the calculated check digit.

60 - 52 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1710029368.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine
15 MAREBLU, STE. 100
ALISO VIEJO, CA 92656
Pediatrics
15 MAREBLU, 100
ALISO VIEJO, CA 92656
Ophthalmology
15 MAREBLU, SUITE 260
ALISO VIEJO, CA 92656
Family Medicine
15 MAREBLU, SUITE 100
ALISO VIEJO, CA 92656
Internal Medicine (Infectious Disease)
15 MAREBLU, SUITE 310
ALISO VIEJO, CA 92656
Dentist
15 MAREBLU, SUITE 280
ALISO VIEJO, CA 92656
Dentist (General Practice)
15 MAREBLU, SUITE 280
ALISO VIEJO, CA 92656
Dentist (General Practice)
15 MAREBLU, SUITE 300
ALISO VIEJO, CA 92656
Specialist
15 MAREBLU, SUITE 340
ALISO VIEJO, CA 92656
Dentist (Endodontics)
15 MAREBLU, SUITE 210
ALISO VIEJO, CA 92656
Dentist (General Practice)
15 MAREBLU, SUITE 320
ALISO VIEJO, CA 92656
Family Medicine
15 MAREBLU, SUITE 310
ALISO VIEJO, CA 92656
Ophthalmology
15 MAREBLU, SUITE # 260
ALISO VIEJO, CA 92656
Clinic/Center (Primary Care)
15 MAREBLU, SUITE 350
ALISO VIEJO, CA 92656
Dentist (General Practice)
15 MAREBLU, SUITE 380
ALISO VIEJO, CA 92656
Acupuncturist
15 MAREBLU, SUITE 310
ALISO VIEJO, CA 92656
Dentist (General Practice)
15 MAREBLU, SUITE 360
ALISO VIEJO, CA 92656
Dentist (General Practice)
15 MAREBLU, SUITE #320
ALISO VIEJO, CA 92656
Podiatrist (Foot & Ankle Surgery)
15 MAREBLU, SUITE 240
ALISO VIEJO, CA 92656
Family Medicine
15 MAREBLU, 100
ALISO VIEJO, CA 92656

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1710029368, enumerated as an "organization" on February 12, 2007.

The provider is located at 15 MAREBLU SUITE 100 ALISO VIEJO, CA 92656 and the phone number is (949) 448-0656.

Non-Pharmacy Dispensing Site with taxonomy code 332900000X.