Medrev

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

MEDREV

Practice address

558 Chelsea Way
Corona, CA 92879-5880

Phone

(951) 772-9355

NPI assigned

May 8, 2019

Organization subpart

No

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

Authorized official

Name

Chelsea Mari

Title

Owner

Phone

(951) 772-9355

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557273600000",
    "number": "1669037362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 CHELSEA WAY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928795880",
            "telephone_number": "951-772-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 CHELSEA WAY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928795880",
            "telephone_number": "951-772-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDREV",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-08",
        "last_updated": "2019-05-08",
        "status": "A",
        "authorized_official_last_name": "MARI",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-772-9355"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• PACE Provider Organization in Corona, CA
• Providers in Corona, CA by specialty
• PACE Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.