Provider Demographics
NPI:1659552016
Name:MC MEDICAL MANAGEMENT, CORP
Entity Type:Organization
Organization Name:MC MEDICAL MANAGEMENT, CORP
Other - Org Name:MC THERAPUTIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINTRYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-836-5225
Mailing Address - Street 1:2424 N GRAND AVE
Mailing Address - Street 2:SUITE J
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8755
Mailing Address - Country:US
Mailing Address - Phone:714-836-5225
Mailing Address - Fax:714-836-2555
Practice Address - Street 1:960 N TUSTIN ST
Practice Address - Street 2:#254
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-5956
Practice Address - Country:US
Practice Address - Phone:714-836-5225
Practice Address - Fax:714-836-5255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization