Healthcare Provider Details

I. General information

NPI: 1194577981
Provider Name (Legal Business Name): CORNERHEALTH MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2077 HARBOR BLVD STE 100
COSTA MESA CA
92627-9384
US

IV. Provider business mailing address

2077 HARBOR BLVD STE 100
COSTA MESA CA
92627-9384
US

V. Phone/Fax

Practice location:
  • Phone: 949-740-7117
  • Fax:
Mailing address:
  • Phone: 949-740-7117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NGUYEN-HUONG LUU
Title or Position: SECRETARY
Credential: PHARMD
Phone: 949-740-7117