Provider Demographics
NPI:1265163182
Name:METAMEDCENTER, INC.
Entity type:Organization
Organization Name:METAMEDCENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:VIERREGGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-484-8000
Mailing Address - Street 1:8081 STANTON AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-3246
Mailing Address - Country:US
Mailing Address - Phone:714-484-8000
Mailing Address - Fax:714-484-8800
Practice Address - Street 1:8081 STANTON AVE STE 300
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-3246
Practice Address - Country:US
Practice Address - Phone:714-484-8000
Practice Address - Fax:714-484-8800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1447699582Medicaid