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

Active since February 12, 2007CLIA 05D0945796 · Microscopy
29472 AVENIDA DE LAS BANDERA, RANCHO SANTA MARGARITA, CA 92688(949) 459-9968 Get Directions Write a Review

NPPES record last updated: April 3, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Memorialcare Medical Group - Rancho Santa Margarita NPPES

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

MEMORIALCARE MEDICAL GROUP - RANCHO SANTA MARGARITA (NPI 1912049578) is a healthcare organization registered as a non-pharmacy dispensing site in Rancho Santa Margarita, California and active in the NPI registry since February 2007. The organization holds a CLIA Microscopy certificate valid through May 10, 2028 and lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1912049578
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameMEMORIALCARE MEDICAL GROUP, INC.
Location Address29472 AVENIDA DE LAS BANDERARancho Santa Margarita, CA 92688-2651
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705 · (858) 625-2990
Phone(949) 459-9968
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 625-2990
Enumeration DateFebruary 12, 2007
Last NPPES UpdateApril 3, 2013
✔ NPI 1912049578 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 · C52292
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.)
29472 AVENIDA DE LAS BANDERA, Rancho Santa Margarita, CA 92688
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Other Names 1

Doing Business AsMemorialcare Medical Group - Rancho Santa Margarita

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 for Provider-Performed Microscopy Procedures (PPMP) 05D0945796

Memorialcare Medical Group · Rancho Santa Margarita, CA
Active · expires May 10, 2028
CLIA Number05D0945796
Laboratory TypePhysician Office
Certificate Effective DateMay 11, 2026
Certificate Expiration DateMay 10, 2028
Laboratory DirectorMark S. Cianciola
Laboratory Phone(949) 459-9968
Laboratory LocationMemorialcare Medical Group29472 Avenida De Las Banderas, Rancho Santa Margarita, CA 92688
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 12

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

RYAN K AH SAN PA-C
Physician Assistant (Medical)
29472 AVENIDA DE LAS BANDERA
RANCHO SANTA MARGARITA, CA 92688
Orange County (949) 459-9968
DR. ERIC J WONG MD
Pediatrics
29472 AVENIDA DE LAS BANDERA
RANCHO SANTA MARGARITA, CA 92688
Orange County (949) 459-9968
DR. LILIAN B TRAN MD
Internal Medicine
29472 AVENIDA DE LAS BANDERA
RANCHO SANTA MARGARITA, CA 92688
Orange County (949) 459-9968
DR. SCOTT SHIFFMAN MD
Family Medicine
29472 AVENIDA DE LAS BANDERA
RANCHO SANTA MARGARITA, CA 92688
Orange County (949) 459-9968
MR. KENNETH A KAZENELSON M.D.
Family Medicine
29472 AVENIDA DE LAS BANDERA
RANCHO SANTA MARGARITA, CA 92688
Orange County (949) 459-9968
DR. SUMANT NAGARKAR MD
Family Medicine
29472 AVENIDA DE LAS BANDERA
RANCHO SANTA MARGARITA, CA 92688
Orange County (949) 459-9968
DR. BONNIE PITTALUGA MD
Pediatrics
29472 AVENIDA DE LAS BANDERA
RANCHO SANTA MARGARITA, CA 92688
Orange County (949) 459-9968
DR. DAIZY ENGINEER MD
Pediatrics
29472 AVENIDA DE LAS BANDERA
RANCHO SANTA MARGARITA, CA 92688
Orange County (949) 459-9968

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 Group, Inc.'s NPI number?

The NPI number for Memorialcare Medical Group, Inc. is 1912049578. It was assigned to this organization in the NPPES registry on February 12, 2007. The provider is doing business as Memorialcare Medical Group - Rancho Santa Margarita.

Where is Memorialcare Medical Group, Inc. located?

Memorialcare Medical Group, Inc. is located at 29472 Avenida De Las Bandera, Rancho Santa Margarita, CA 92688. The listed phone number is (949) 459-9968.

What is Memorialcare Medical Group, Inc.'s specialty?

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

Does Memorialcare Medical Group, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0945796) is associated with this NPI, valid through May 10, 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 Memorialcare Medical Group, Inc. was last updated on April 3, 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.