Memorialcare Medical Foundation

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

MEMORIALCARE MEDICAL FOUNDATION

Practice address

18111 Brookhurst St., Ste 6100
Fountain Valley, CA 92708-6728

Phone

(714) 378-7330

Fax

(714) 377-0003

NPI assigned

Feb 25, 2022

Organization subpart

Yes

Parent organization

MEMORIAL HEALTH SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Tanya Dansky, M.D.

Title

Senior Medical Director

Phone

(657) 241-3499

Specialties & licenses 1

Addresses

Other names 1

• MemorialCare Medical Group Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Memorialcare Medical Foundation3 organizations share this tax ID, including this one

Part of

Joseph Moskowitz MD Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Memorialcare Medical Foundation

  • Non-Pharmacy Dispensing Site
  • Newport Beach, CA
  • NPI 1760135677
  NPD tax ID
• Memorialcare Medical Foundation

  • Non-Pharmacy Dispensing Site
  • Orange, CA
  • NPI 1871246777
  NPD tax ID

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1912653288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST., STE 6100",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "714-378-7330",
            "fax_number": "714-377-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST., STE 6100",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "714-378-7330",
            "fax_number": "714-377-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIALCARE MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HEALTH SERVICES, INC.",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A",
        "authorized_official_last_name": "DANSKY",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "SENIOR MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "657-241-3499",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MemorialCare Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MemorialCare Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natasha Marie Melton, OTD, OTR/L
• Melvyn H. Novegrod, M.D., Inc.
• Memorial Care Surgical Center at Orange Coast, LLC
• Memorial Radiation Oncology Medical
• Memorialcare Medical Foundation
• Memorialcare Select Health Plan
• Juliana Menchaca, BCBA
• Meg Menchavez, BS, AS
• Candie Mendez, B.A
• Kyla Sabrina Mendez

• Non-Pharmacy Dispensing Site in Fountain Valley, CA
• Providers in Fountain Valley, 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 Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.