Organization Active NPI

Medical Healing Center

  • Specialist
  • Lake Forest, CA
National Provider Identifier
1831302272
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
5374 Issued in CA
Legal business name
MEDICAL HEALING CENTER
Practice address
23361 El Toro Rd Ste 106
Lake Forest, CA 92630-4810
Phone
(949) 855-8119
Fax
(949) 855-6328
NPI assigned
May 8, 2007
Last updated
Jun 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Mr. Joe Matthew Hercenko
Title
Biller
Phone
(949) 855-8119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5374 CA Primary

Addresses

Primary practice location

23361 El Toro Rd Ste 106
Lake Forest, CA 92630-4810

Mailing address

23361 El Toro Rd Ste 106
Lake Forest, CA 92630-4810
Phone (949) 855-8119

National Provider Directory

National Provider Directory

Locations

23361 El Toro Rd
Ste 106
Lake Forest, CA 92630
Phone (949) 855-8119

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1831302272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23361 EL TORO RD STE 106",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304810",
            "telephone_number": "949-855-8119",
            "fax_number": "949-855-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23361 EL TORO RD STE 106",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304810",
            "telephone_number": "949-855-8119",
            "fax_number": "949-855-6328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL HEALING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "HERCENKO",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "949-855-8119",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "5374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.