MEMORIALCARE MEDICAL GROUP
NPI 1871246777
Non-Pharmacy Dispensing Site in Orange, CA

Q: What is Memorialcare Medical Foundation's NPI number?

The NPI number for Memorialcare Medical Foundation is 1871246777. It was assigned to this organization in the NPPES registry on January 31, 2022. The provider is doing business as Memorialcare Medical Group.

Q: What is Memorialcare Medical Foundation's specialty?

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

Active since January 31, 2022CLIA 05D2019393 · Waiver

230 S. MAIN ST, SUITE 100, ORANGE, CA 92868(714) 541-0101(714) 541-0450 Get Directions Write a Review

NPPES record last updated: March 23, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Memorialcare Medical Group NPPES

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

MEMORIALCARE MEDICAL GROUP (NPI 1871246777) is a healthcare organization registered as a non-pharmacy dispensing site in Orange, California and active in the NPI registry since January 2022. The organization holds a CLIA Waiver certificate valid through January 31, 2027, maintains a secondary practice location in Fountain Valley, and lists Tanya Dansky, Mcmf - Senior Medical Director, as its authorized official.

NPPES Registry Identity

NPI1871246777

Entity TypeOrganization

Primary Taxonomy332900000X

Legal Business NameMEMORIALCARE MEDICAL FOUNDATION

Location Address230 S. MAIN ST, SUITE 100Orange, CA 92868

Mailing Address230 S. Main St, Suite 100Orange, CA 92868 · (714) 541-0101 · Fax (714) 541-0450

Phone(714) 541-0101

Fax(714) 541-0450

Organization SubpartYesParent: Memorial Health Services, Inc.

Authorized OfficialTanya DanskyMcmf - Senior Medical Director · (657) 241-3499

Enumeration DateJanuary 31, 2022

Last NPPES UpdateMarch 23, 2022

NPPES CertifiedMarch 23, 2022

✔ NPI 1871246777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers

Taxonomy Code332900000X

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.)

230 S. MAIN ST, SUITE 100, Orange, CA 92868

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Other Names 1

Doing Business AsMemorialcare Medical Group

Secondary Practice Location 1

Location 118111 Brookhurst St., Ste 6100Fountain Valley, CA 92708-6728 · Phone (714) 378-7330 · Fax (714) 377-0003

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 05D2019393

Memorialcare Medical Group · Fountain Valley, CA

Active · expires Jan 31, 2027

CLIA Number05D2019393

Laboratory TypePhysician Office

Certificate Effective DateFebruary 1, 2025

Certificate Expiration DateJanuary 31, 2027

Laboratory DirectorJack F. Jacoub MD

Laboratory Phone(714) 378-7330

Laboratory LocationMemorialcare Medical Group18111 Brookhurst St, Ste 6100, Fountain Valley, CA 92708

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Memorialcare Medical Foundation's NPI number?

The NPI number for Memorialcare Medical Foundation is 1871246777. It was assigned to this organization in the NPPES registry on January 31, 2022. The provider is doing business as Memorialcare Medical Group.

Where is Memorialcare Medical Foundation located?

Memorialcare Medical Foundation is located at 230 S. Main St, Suite 100, Orange, CA 92868. The listed phone number is (714) 541-0101.

What is Memorialcare Medical Foundation's specialty?

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

Does Memorialcare Medical Foundation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2019393) is associated with this NPI, valid through January 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Memorialcare Medical Foundation was last updated on March 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.