Organization
MEMORIALCARE MEDICAL GROUP, INC.
Active
Parent organization
MEDVANTX, INC
Other names
MemorialCare Medical Group - Irvine - Yale Loop
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
4050 BARRANCA PKWY, SUITE 200, IRVINE, CA 92604-7706
(949) 551-1090
Mailing address
9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701
(858) 625-2990
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G21256
CA
Other
Enumeration date
02/13/2007
Last updated
11/04/2015
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