San Juan Family Health Urgent Care Medical Center

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

20A6385 Issued in CA

Legal business name

SAN JUAN FAMILY HEALTH URGENT CARE MEDICAL CENTER

Practice address

32112 Camino Capistrano
San Juan Capistrano, CA 92675-3717

Phone

(949) 248-9797

Fax

(949) 388-3336

NPI assigned

Aug 25, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Shahrokh Poormehr, D.O.

Title

D.O., President

Phone

(949) 248-9797

Specialties & licenses 3

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1188000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1497948194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32112 CAMINO CAPISTRANO",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753717",
            "telephone_number": "949-248-9797",
            "fax_number": "949-388-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32112 CAMINO CAPISTRANO",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753717",
            "telephone_number": "949-248-9797",
            "fax_number": "949-388-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN FAMILY HEALTH URGENT CARE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-25",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "POORMEHR",
        "authorized_official_first_name": "SHAHROKH",
        "authorized_official_title_or_position": "D.O., PRESIDENT",
        "authorized_official_telephone_number": "949-248-9797",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6385",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "20A6385",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CA",
            "license": "20A6385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX63850",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC5333",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "20A6385",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ57256Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phillip A Sainz, PTA
• Stephanie Saito Tyson, DC
• Brooke Sampson
• Samuel L. Kipper, M.D., Inc.
• San Juan Capistrano Surgery Center,LLC
• San Juan Pediatrics Inc
• San Juan Pharmacy
• Chantal Angela Sanchez
• Guadalupe Cristal Sanchez
• Michele Denise Sandberg

• Urgent Care Clinic/Center in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Urgent Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.