BOLSA MEDICAL GROUP
NPI 1720423833
Non-Pharmacy Dispensing Site in Westminster, CA

NPI Status: Active since May 02, 2013

Contact Information

10362 BOLSA AVE
SUITE 110
WESTMINSTER, CA
ZIP 92683
Phone: (714) 531-2091

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  • Organization
  • Non-Pharmacy Dispensing Site
  • CLIA Number: 05D0891062
  • CLIA Cert. Type: Practitioner Other
  • CLIA Exp. Date: 05-01-2026

About BOLSA MEDICAL GROUP

This page provides the complete NPI Profile along with additional information for Bolsa Medical Group, a provider established in Westminster, California operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1720423833 assigned on May 2013. The practitioner's primary taxonomy code is 332900000X with license number A70808 (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 Bolsa Medical Group. The authorized official of this NPI record is Kenny Heine (Vp Of Operations)

NPI
1720423833
Provider Legal Name
BOLSA MEDICAL GROUP
Other Organization Name
BOLSA MEDICAL GROUP
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
10362 BOLSA AVE SUITE 110 WESTMINSTER, CA 92683
Location Phone
(714) 531-2091
Mailing Address
5626 OBERLIN DR SUITE 110 SAN DIEGO, CA 92121
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
05-02-2013
Last Update Date
05-02-2013
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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.
A70808
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) 964-1506

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
05D0891062
Facility Type
Practitioner Other
Certificate Effective Date
May 02, 2024
Certificate Expiration Date
May 01, 2026
Laboratory Director
CO PHAM, MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Bolsa Medical Group to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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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 1720423833, 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 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.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
2
Doubled → 4
Pos 4
0
Unchanged
Pos 5
4
Doubled → 8
Pos 6
2
Unchanged
Pos 7
3
Doubled → 6
Pos 8
8
Unchanged
Pos 9
3
Doubled → 6
Check
3
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 2 → 4 4 → 8 3 → 6 3 → 6

Step 2: Add all digits plus the NPI constant

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

2 + 7 + 4 + 0 + 8 + 2 + 6 + 8 + 6 + 24 = 67

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

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1720423833.

Other Providers at the Same Location


The following 11 providers are registered at the same or a nearby location.

Obstetrics & Gynecology
10362 BOLSA AVE, BOLSA MEDICAL GROUP
WESTMINSTER, CA 92683
Ophthalmology
10362 BOLSA AVE, STE 201
WESTMINSTER, CA 92683
Pediatrics
10362 BOLSA AVE, BOLSA MEDICAL GROUP
WESTMINSTER, CA 92683
Pediatrics
10362 BOLSA AVE, BOLSA MEDICAL GROUP
WESTMINSTER, CA 92683
Surgery
10362 BOLSA AVE, BOLSA MEDICAL GROUP
WESTMINSTER, CA 92683
Pediatrics
10362 BOLSA AVE, BOLSA MEDICAL GROUP
WESTMINSTER, CA 92683
Obstetrics & Gynecology
10362 BOLSA AVE, BOLSA MEDICAL GROUP
WESTMINSTER, CA 92683
Registered Nurse
10362 BOLSA AVE
WESTMINSTER, CA 92683
Specialist
10362 BOLSA AVE
WESTMINSTER, CA 92683
Pharmacy (Community/Retail Pharmacy)
10362 BOLSA AVE, SUITE 108
WESTMINSTER, CA 92683
Surgery
10362 BOLSA AVE
WESTMINSTER, CA 92683

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1720423833, enumerated as an "organization" on May 02, 2013.

The provider is located at 10362 BOLSA AVE SUITE 110 WESTMINSTER, CA 92683 and the phone number is (714) 531-2091.

Non-Pharmacy Dispensing Site with taxonomy code 332900000X.