Provider Demographics
NPI:1861769069
Name:MEDX HEALTH CARE INC
Entity type:Organization
Organization Name:MEDX HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RANK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-836-8120
Mailing Address - Street 1:777 CORPORATE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-2136
Mailing Address - Country:US
Mailing Address - Phone:949-481-8881
Mailing Address - Fax:949-481-6666
Practice Address - Street 1:777 CORPORATE DR STE 150
Practice Address - Street 2:
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-2136
Practice Address - Country:US
Practice Address - Phone:949-836-8120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73486207Q00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty