Organization
MEDMGR MSO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYA GABRIELLE MORALES (LEAD, CREDENTIALING)
(714) 487-4482
Entity
Organization
Contact information
Practice address
1520 NUTMEG PL STE 210, COSTA MESA, CA 92626-2597
(800) 698-6151
Mailing address
1520 NUTMEG PL STE 210, COSTA MESA, CA 92626-2597
(800) 698-6151
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
07/23/2025
Last updated
07/23/2025
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