MEDICARE: CORNERHEALTH MEDICAL GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1194577981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNERHEALTH MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	2077 HARBOR BLVD STE 100
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92627-9384
Country	:	US
Telephone Number	:	949-740-7117
Fax Number	:

Provider Business Practice Location Address
First Line	:	2077 HARBOR BLVD STE 100
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92627-9384
Country	:	US
Telephone Number	:	949-740-7117
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	NGUYEN-HUONG LUU
Credential	:	PHARMD
Telephone Number	:	949-740-7117

Provider Enumeration Date	:	04/04/2024
Last Update Date	:	07/11/2025

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