Organization · Type 2 NPI

Memorialcare Medical Foundation

Non-Pharmacy Dispensing Site · Fountain Valley, CA

NPI number 1912653288 Active

Practice location

18111 Brookhurst St., Ste 6100
Fountain Valley, CA 92708-6728

Fax (714) 377-0003

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	None listed

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

Other non-pharmacy dispensing site providers in Fountain Valley

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NPI record

NPI: 1912653288
Entity type: Organization (Type 2)
Issued: Feb 25, 2022
Last updated: Sep 9, 2022
Status: Active
Subpart: Yes of Memorial Health Services, Inc.

Other names

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Memorialcare Medical Group · doing business as
Memorialcare Medical Group · doing business as

Authorized official

Tanya Dansky, MD
Senior Medical Director
(657) 241-3499

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About NPI 1912653288

Memorialcare Medical Foundation's National Provider Identifier is 1912653288, issued on Feb 25, 2022. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Fountain Valley, CA. The record was last updated on Sep 9, 2022.