MEMORIALCARE MEDICAL GROUP - RANCHO SANTA MARGARITA
NPI 1912049578
Non-Pharmacy Dispensing Site in Rancho Santa Margarita, CA

NPI Status: Active since February 12, 2007

Contact Information

29472 AVENIDA DE LAS BANDERA
RANCHO SANTA MARGARITA, CA
ZIP 92688
Phone: (949) 459-9968

NPI Profile Information
Primary Taxonomy
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Non-Pharmacy Dispensing Site
CLIA Number: 05D0945796
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 05-10-2028

About MEMORIALCARE MEDICAL GROUP - RANCHO SANTA MARGARITA

This page provides the complete NPI Profile along with additional information for Memorialcare Medical Group - Rancho Santa Margarita, a provider established in Rancho Santa Margarita, California operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1912049578 assigned on February 2007. The practitioner's primary taxonomy code is 332900000X with license number C52292 (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 - Rancho Santa Margarita. The authorized official of this NPI record is Kenny Heine (Vp Of Operations)

NPI: 1912049578
Provider Legal Name: MEMORIALCARE MEDICAL GROUP, INC.
Other Organization Name: MEMORIALCARE MEDICAL GROUP - RANCHO SANTA MARGARITA
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 29472 AVENIDA DE LAS BANDERA RANCHO SANTA MARGARITA, CA 92688
Location Phone: (949) 459-9968
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.: C52292
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: 05D0945796
Facility Type: Physician Office
Certificate Effective Date: May 11, 2026
Certificate Expiration Date: May 10, 2028
Laboratory Director: MARK S. CIANCIOLA
Certificate Type: Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description: This CLIA certificate is issued to Memorialcare Medical Group - Rancho Santa Margarita 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.

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 1912049578, 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 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

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 2

Pos 4

Unchanged

Pos 5

Doubled → 0

Pos 6

Unchanged

Pos 7

Doubled → 18 → 1 + 8

Pos 8

Unchanged

Pos 9

Doubled → 14 → 1 + 4

Check

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 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

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

2 + 9 + 2 + 2 + 0 + 4 + 1 + 8 + 5 + 1 + 4 + 24 = 62

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

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8

This NPI is valid

The calculated check digit is 8, which matches the last digit of 1912049578.