Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
SAN CLEMENTE FAMILY MEDICINE
Active
Organization
SAN CLEMENTE FAMILY MEDICINE
Active
Other names
Memorial Family Medicine Medical Group, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN YVONNE MELVIN D.O. (PRESIDENT/CEO)
(562) 933-0055
Entity
Organization
Contact information
Practice address
1300 AVENIDA VISTA HERMOSA, SUITE 200, SAN CLEMENTE, CA 92673-6315
(949) 452-3199
(949) 218-6866
Mailing address
450 E SPRING ST, SUITE 1, LONG BEACH, CA 90806-1625
(562) 933-0053
(562) 933-0079
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0071000
—
CA
Enumeration date
06/21/2010
Last updated
06/21/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up