Med Center Medical Clinic

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

53113 Issued in CA

Legal business name

MED CENTER MEDICAL CLINIC

Practice address

6651 Madison Ave
Carmichael, CA 95608-0602

Phone

(916) 965-1111

NPI assigned

Nov 27, 2013

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

VP of Operations

Phone

(858) 964-1506

Specialties & licenses 1

Addresses

Other names 1

• Med Center Doing business as

Part of

Tri - State Medical Group Inc

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385510400000",
    "number": "1902237076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6651 MADISON AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080602",
            "telephone_number": "916-965-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED CENTER MEDICAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2013-11-27",
        "last_updated": "2013-11-27",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "53113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alison McMorris
• Henry E McNeely, M.D.
• Warren R McWilliams III, DDS
• Andrea B Means
• Med Center Medical Clinic
• Med-7 Urgent Care Center Medical Group
• Stephen Joseph Medawar, DPM
• Natalie Mefferd
• Milad Mehrbod, MD
• Robyn Denise Mello, OTR/L

• Non-Pharmacy Dispensing Site in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Non-Pharmacy Dispensing Site in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; 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.