Medical Staff Application Request
The following criteria must be met prior to applying for Medical Staff:
Current California Medical License (or in process of obtaining one)
Currently have or are actively engaged in acquiring professional liability insurance policy with limits of coverage in the amounts of $1 million per occurrence and $3 million aggregate per physician per year, commensurate with the privileges you will be requesting. Policy must be in effect before the completion of the application process
Board Certified in primary specialty (or have documentation of active involvement in the board certification process)
If close proximity to the hospital is a requirement of your specialty, you have an office within a reasonable distance to allow continuous care for hospitalized patients
Not currently excluded or denied participation from any health care program funded in whole or in part by the federal government or any state health care program including, but not limited to, Medicare or Medi-Cal and are not aware of any pending actions regarding potential exclusions from these programs
Have provider coverage in your absence with providers currently on staff at the hospital(s) you are applying to
I attest that I have read and understand the qualifications for medical staff eligibility listed above
Pathology, Radiology, Anesthesiology, or Emergency Medicine providers please call the applicable Medical Staff Office listed below to request an application as these particular specialties require a contractual relationship with our medical centers. Please also note that Neonatology providers at Orange Coast Medical Center need to be affiliated with Orange Coast Medical Center's contracted Neonatology group.
Allied Health Providers Please contact the applicable Medical Staff Office to request an application.
Medical Staff Offices:
Long Beach Medical Center and Miller Children's & Women's Hospital Long Beach - (562) 933-1248
Orange Coast Medical Center - (714) 378-7920
Saddleback Medical Center - (949) 452-3619
Please provide us with the following information to request an application for Medical Staff at a MemorialCare Medical Center:
Your NPI Number is required on the medical staff application. If you do not have an NPI Number please go to:
and apply for an NPI number, so you have it readily available when you complete the application.
Please select the MemorialCare Hospital(s) at which you are requesting membership and/or privileges. If applying at more than one hospital, you will be prompted with a popup to choose which hospital will be considered your primary facility:
Long Beach Medical Center
Miller Children's & Women's Hospital Long Beach
Orange Coast Medical Center
Saddleback Medical Center