SAND CANYON MEDICAL GROUP
NPI 1962688390
Clinic/Center - Urgent Care in Irvine, CA

Active since January 16, 2008CLIA 05D0981347 · Waiver
16100 SAND CANYON AVE, SUITE 150, IRVINE, CA 92618(949) 417-0272 Get Directions Write a Review

NPPES record last updated: August 13, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Sand Canyon Medical Group NPPES

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

SAND CANYON MEDICAL GROUP (NPI 1962688390) is a healthcare organization registered as an urgent care in Irvine, California and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through December 21, 2026 and lists Matthew Mullarky, President, as its authorized official.

NPPES Registry Identity

NPI1962688390
Entity TypeOrganization
Primary Taxonomy261QU0200X
Legal Business NameSAND CANYON MEDICAL GROUP
Location Address16100 SAND CANYON AVE, SUITE 150Irvine, CA 92618-3716
Mailing AddressPo Box 96365Oklahoma City, OK 73143-6365
Organization SubpartNo
Authorized OfficialMatthew MullarkyPresident · (949) 417-0272
Enumeration DateJanuary 16, 2008
Last NPPES UpdateAugust 13, 2008
NPI 1962688390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Urgent CareAmbulatory Health Care Facilities
Taxonomy Code261QU0200X
16100 SAND CANYON AVE, Irvine, CA 92618

Other Identifiers 1

Medicare PINW22621CA

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 05D0981347

Sand Canyon Medical Group · Irvine, CA
Active · expires Dec 21, 2026
CLIA Number05D0981347
Laboratory TypeOther
Certificate Effective DateDecember 22, 2024
Certificate Expiration DateDecember 21, 2026
Laboratory DirectorThomas K. Ryu Do
Laboratory Phone(949) 417-0272
Laboratory LocationSand Canyon Medical Group15775 Laguna Canyon Road #100, Irvine, CA 92618
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

Internal Medicine (Gastroenterology)
16100 SAND CANYON AVE, #260
IRVINE, CA 92618
Emergency Medicine (Emergency Medical Services)
16100 SAND CANYON AVE, SUITE 150
IRVINE, CA 92618
Internal Medicine (Endocrinology, Diabetes & Metabolism)
16100 SAND CANYON AVE, SUITE 260
IRVINE, CA 92618
Dentist (Periodontics)
16100 SAND CANYON AVE, SUITE 320
IRVINE, CA 92618
Internal Medicine
16100 SAND CANYON AVE, 250
IRVINE, CA 92618
Clinic/Center (Ambulatory Surgical)
16100 SAND CANYON AVE, SUITE 170
IRVINE, CA 92618
Nurse Practitioner (Family)
16100 SAND CANYON AVE, ST 130
IRVINE, CA 92618
Surgery (Vascular Surgery)
16100 SAND CANYON AVE, SUITE #350
IRVINE, CA 92618

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 Sand Canyon Medical Group's NPI number?

The NPI number for Sand Canyon Medical Group is 1962688390. It was assigned to this organization in the NPPES registry on January 16, 2008.

Where is Sand Canyon Medical Group located?

Sand Canyon Medical Group is located at 16100 Sand Canyon Ave Suite 150, Irvine, CA 92618. The listed phone number is (949) 417-0272.

What is Sand Canyon Medical Group's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.

Does Sand Canyon Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0981347) is associated with this NPI, valid through December 21, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sand Canyon Medical Group was last updated on August 13, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.