# MED CENTER MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDVANTX, INC.
- **Other names:** Med Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902237076
- **Legal business name:** MEDVANTX, INC.
- **Authorized official:** KENNY HEINE (VP OF OPERATIONS)
- **Authorized official phone:** (858) 964-1506

## Contact information

- **Practice address:** 6651 MADISON AVE, CARMICHAEL, CA 95608-0602
- **Practice address phone:** (916) 965-1111
- **Mailing address:** 5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | 53113 | CA | Yes |

## Other

- **Enumeration date:** 11/27/2013
- **Last updated:** 11/27/2013