Memorial Care Surgical Center at Orange Coast, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MEMORIAL CARE SURGICAL CENTER AT ORANGE COAST, LLC

Practice address

18111 Brookhurst Street
3200 Suite
Fountain Valley, CA 92708

Phone

(951) 378-3738

NPI assigned

Mar 17, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cheryl R Jacob

Title

VP Operations

Phone

(714) 378-7412

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Memorial Care Surgical Center at Orange Coast LLCCCN 05C0001923

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Member Of

  NPD member
• Dignity Health

  • Neurological Surgery Physician
  • Henderson, NV
  • NPI 1720358039

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252627200000",
    "number": "1114168309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST STREET",
            "address_2": "3200 SUITE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "951-378-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST STREET",
            "address_2": "3200 SUITE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "951-378-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL CARE SURGICAL CENTER AT ORANGE COAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2009-09-11",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VP OPERATIONS",
        "authorized_official_telephone_number": "714-378-7412",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Violeta Amanda Mejia
• Melanie Lin MD, a Professional Corporation
• Alexis Melendez, MED
• Natasha Marie Melton, OTD, OTR/L
• Melvyn H. Novegrod, M.D., Inc.
• Memorial Radiation Oncology Medical
• Memorialcare Medical Foundation
• Memorialcare Medical Foundation
• Memorialcare Select Health Plan
• Juliana Menchaca, BCBA

• Ambulatory Surgical Clinic/Center in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.