Memorialcare Select Health Plan

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

9330495 Issued in CA

Legal business name

MEMORIALCARE SELECT HEALTH PLAN

Practice address

17360 Brookhurst St
Fountain Valley, CA 92708-3720

Phone

(855) 367-7747

Fax

(657) 241-3960

NPI assigned

May 24, 2013

Organization subpart

Yes

Parent organization

MEMORIAL HEALTH SERVICESAs reported in NPPES

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

Authorized official

Name

Ms. Maribel Ferrer

Title

Ceo

Phone

(855) 367-7747

Specialties & licenses 1

Addresses

Electronic endpoints 1

Part of

Joseph Moskowitz MD Inc

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1407293814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720",
            "telephone_number": "855-367-7747",
            "fax_number": "657-241-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720",
            "telephone_number": "855-367-7747",
            "fax_number": "657-241-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIALCARE SELECT HEALTH PLAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HEALTH SERVICES",
        "enumeration_date": "2013-05-24",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "FERRER",
        "authorized_official_first_name": "MARIBEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-367-7747",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "9330495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.memorialcareselecthealthplan.org/",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melvyn H. Novegrod, M.D., Inc.
• Memorial Care Surgical Center at Orange Coast, LLC
• Memorial Radiation Oncology Medical
• Memorialcare Medical Foundation
• Memorialcare Medical Foundation
• Juliana Menchaca, BCBA
• Meg Menchavez, BS, AS
• Candie Mendez, B.A
• Kyla Sabrina Mendez
• Liliana Mendez, ACSW

• Health Maintenance Organization in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.