Bristol Park Medical Group
NPI 1881736445ActiveOrganization· Non-Pharmacy Dispensing Site· Costa Mesa, CA
Non-Pharmacy Dispensing Site in Costa Mesa, California, registered in NPPES in February 2007, part of Medvantx, Inc. The authorized official on file is Kenny Heine, Director Of Operations.
Overview
| NPI | 1881736445 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Medvantx, Inc. |
| NPI issued | Feb 12, 2007 |
| Last updated in NPPES | May 29, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Non-Pharmacy Dispensing Site Primary | 332900000X | A87971 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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