1. Home
  2. Directory
  3. California
  4. Westminster
  5. Non Pharmacy Dispensing Site
  6. NPI Profile

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

Active since May 02, 2013CLIA 05D0891062 · Waiver
10362 BOLSA AVE, SUITE 110, WESTMINSTER, CA 92683(714) 531-2091 Get Directions Write a Review

NPPES record last updated: May 2, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bolsa Medical Group NPPES

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

BOLSA MEDICAL GROUP (NPI 1720423833) is a healthcare organization registered as a non-pharmacy dispensing site in Westminster, California and active in the NPI registry since May 2013. The organization holds a CLIA Waiver certificate valid through May 1, 2028 and lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1720423833
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameBOLSA MEDICAL GROUP
Location Address10362 BOLSA AVE, SUITE 110Westminster, CA 92683-6763
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Phone(714) 531-2091
Organization SubpartYesParent: Medvantx, Inc,
Authorized OfficialKenny HeineVp Of Operations · (858) 964-1506
Enumeration DateMay 2, 2013
✔ NPI 1720423833 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in CA · A70808
Definition
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.)
10362 BOLSA AVE, Westminster, CA 92683
Open in Google Maps ↗

Other Names 1

Doing Business AsBolsa Medical 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 of Waiver 05D0891062

Bolsa Medical Group · Westminster, CA
Active · expires May 1, 2028
CLIA Number05D0891062
Laboratory TypePractitioner Other
Certificate Effective DateMay 2, 2026
Certificate Expiration DateMay 1, 2028
Laboratory DirectorCo Pham, MD
Laboratory Phone(714) 531-2091
Laboratory LocationBolsa Medical Group10362 Bolsa Avenue, Westminster, CA 92683
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

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

DR. MINH QUY HOANG MD
Pediatrics
10362 BOLSA AVE, BOLSA MEDICAL GROUP
WESTMINSTER, CA 92683
Orange County (714) 531-2091
DR. CO DANG LONG PHAM MD
Obstetrics & Gynecology
10362 BOLSA AVE, BOLSA MEDICAL GROUP
WESTMINSTER, CA 92683
Orange County (714) 531-2091
DR. LOC VAN NGUYEN MD
Pediatrics
10362 BOLSA AVE, BOLSA MEDICAL GROUP
WESTMINSTER, CA 92683
Orange County (714) 531-2091
BOI BUI TRINH & TU DUC PHAM PTR
Pharmacy (Community/Retail Pharmacy)
10362 BOLSA AVE, SUITE 108
WESTMINSTER, CA 92683
Orange County (714) 775-0772
KHIEM PV NGUYEN MD CARDIOLOGY ASSOCIATES MEDICAL GROUP INC
Specialist
10362 BOLSA AVE
WESTMINSTER, CA 92683
Orange County (714) 531-2091
DR. CHRISTINE THAO HOANG MD
Obstetrics & Gynecology
10362 BOLSA AVE, BOLSA MEDICAL GROUP
WESTMINSTER, CA 92683
Orange County (714) 531-2091
MR. HANG THANH TRAN
Registered Nurse
10362 BOLSA AVE
WESTMINSTER, CA 92683
Orange County (714) 531-2091
DR. THAO NGOC NGUYEN MD
Pediatrics
10362 BOLSA AVE, BOLSA MEDICAL GROUP
WESTMINSTER, CA 92683
Orange County (714) 531-2091

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 Bolsa Medical Group's NPI number?

The NPI number for Bolsa Medical Group is 1720423833. It was assigned to this organization in the NPPES registry on May 2, 2013.

Where is Bolsa Medical Group located?

Bolsa Medical Group is located at 10362 Bolsa Ave Suite 110, Westminster, CA 92683. The listed phone number is (714) 531-2091.

What is Bolsa Medical Group's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Bolsa Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0891062) is associated with this NPI, valid through May 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bolsa Medical Group was last updated on May 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.