Memorial Family Medicine Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MEMORIAL FAMILY MEDICINE MEDICAL GROUP, INC.

Practice address

450 E Spring St
#1
Long Beach, CA 90806-1625

Phone

(562) 933-0050

Fax

(562) 933-0079

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Susan Y Melvin, DO

Title

Ceo

Phone

(562) 933-0055

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Memorial Family Medicine Medical Group, Inc.

  dba San Clemente Family Medicine

  • Family Medicine Physician
  • Long Beach, CA
  • NPI 1922329127
  NPPES parent name

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1689680001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E SPRING ST",
            "address_2": "#1",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061625",
            "telephone_number": "562-933-0050",
            "fax_number": "562-933-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E SPRING ST",
            "address_2": "#1",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061625",
            "telephone_number": "562-933-0050",
            "fax_number": "562-933-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL FAMILY MEDICINE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "MELVIN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-933-0055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Memorial Cardiology Medical Group Inc
• Memorial Cardiology Medical Group, Inc
• Memorial Cardiology Medical Group, Inc
• Memorial Cardiology Medical Group, Inc
• Memorial Cardiology Medical Group, Inc
• Memorial Family Medicine Medical Group, Inc. (San Clemente Family Medicine)
• Memorial Hospitalist Network
• Memorial Maritime Clinic, Inc.
• Memorial Medical Transport
• Memorial Medical Transport, Inc

• Family Medicine Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.