Organization
MEMORIALCARE MEDICAL FOUNDATION
Active
Parent organization
MEMORIAL HEALTH SERVICES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEMORIAL HEALTH SERVICES, INC.
Authorized official
LAURIE SICAEROS (COO/VP PHYSICIAN INTEGRATION)
(877) 696-3622
Entity
Organization
Contact information
Practice address
17360 BROOKHURST ST, FOUNTAIN VALLEY, CA 92708-3720
(877) 696-3622
Mailing address
17360 BROOKHURST ST, FOUNTAIN VALLEY, CA 92708-3720
(877) 696-3622
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
208M00000X
Hospitalist Physician
—
—
213E00000X
Podiatrist
—
—
261Q00000X
Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/28/2010
Last updated
02/27/2024
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