MISSION SURGICAL CLINIC, INC. (NPI# 1457300436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457300436 |
| Entity Type | Organization |
| Organization Name | MISSION SURGICAL CLINIC, INC. |
| Practice Address |
3660 Park Sierra Dr Suite 105 Riverside CA 92505-3071 |
| Mailing Address |
Po Box 2828 Corona CA 92878-2828 |
| Practice Telephone | 9512788870 |
| Practice Fax Number | 9512788913 |
| Mailing Telephone | 9512788870 |
| Mailing Fax Number | 9512788913 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2012-05-03 |
| Authorized Official Name | DR. MICHAEL S. CHIN (PRESIDENT) |
| Authorized Official Telephone | 9512788870 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA16804 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 208600000X | Surgery | 20A10803 | CA | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | G75730 | CA | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 20A9434 | CA | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | G56529 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G565290 | 05 |
| Street Address |
3660 PARK SIERRA DR SUITE 105 |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92505-3071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730734450 | Teresa Pham | Behavior Technician | 3660 Park Sierra Dr, Riverside, CA 92505-3081 | 2019-08-08 |
| 1497261614 | Ly Thanh Duong | Nurse Practitioner | 3660 Park Sierra Dr, Riverside, CA 92505-3081 | 2017-12-26 |
| 1104276393 | Mission Surgical Group | Clinic/Center | 3660 Park Sierra Dr, Riverside, CA 92505-3081 | 2016-06-17 |
| 1326443201 | Neighborhood Health Systems | Non-Pharmacy Dispensing Site | 3660 Park Sierra Dr, Suite 110, Riverside, CA 92505-3081 | 2014-11-04 |
| 1366857039 | Neighborhood Health Systems | Clinic/Center | 3660 Park Sierra Dr, Suite 110, Riverside, CA 92505-3081 | 2014-06-21 |
| 1881991040 | First Call Medical Group | Specialist | 3660 Park Sierra Dr, 101, Riverside, CA 92505-3081 | 2011-02-23 |
| 1053544569 | Doris Sophia Li | Surgery | 3660 Park Sierra Dr, Suite 105, Riverside, CA 92505-3081 | 2009-08-31 |
| 1710137401 | Eric Changchien | Surgery | 3660 Park Sierra Dr, Suite 105, Riverside, CA 92505-3081 | 2008-09-30 |
| 1073761243 | Rizwan Badar | Internal Medicine | 3660 Park Sierra Dr, Suite 208, Riverside, CA 92505-3081 | 2008-08-29 |
| 1700047875 | Tina T Ng | Surgery | 3660 Park Sierra Dr, Suite 105, Riverside, CA 92505-3081 | 2008-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205458460 | Mark Anthony Vargas | Behavioral Analyst | 94193 Flat Rock Dr Ste 220, Riverside, CA 92505 | 2020-05-11 |
| 1568099976 | Victoria Lee | Student in an Organized Health Care Education/Training Program | Riverside Family Medicine Residency, 10800 Magnolia Avenue, Riverside, CA 92505 | 2020-03-25 |
| 1588222087 | A Homecare Services, Inc | In Home Supportive Care | 4193 Flat Rock Road, Building 200 Suite 206, Riverside, CA 92505 | 2019-05-31 |
| 1609302397 | Tap Pharmacy, Inc. | Pharmacy | 4270 Riverwalk Pkwy Ste 102, Riverside, CA 92505 | 2017-05-02 |
| 1467998658 | Onofre Gascon | Behavior Technician | 11711 Collett Ave, #1614, Riverside, CA 92505 | 2017-01-11 |
| 1780038505 | Nash David Martinez | Emergency Medicine | 10800 Magnolia Ave Dept of Emergency Medicine, Kaiser Permanente Hospital, Riverside, CA 92505 | 2016-04-18 |
| 1447639901 | Jose Joel Manalese Dds Inc | Dentist | 3950 Pierce St., Suite L., Riverside, CA 92505 | 2015-05-29 |
| 1821493230 | Jean Huynh | Physician Assistant | 11725 State Ave., Suite 100, Riverside, CA 92505 | 2014-10-28 |
| 1003160649 | Elaf Farahat | Dietitian, Registered | 10800 Magnolia Avenue., Riverside, CA 92505 | 2012-11-05 |
| 1730458217 | Tammy Lynn Gilmore | Non-emergency Medical Transport (VAN) | 10770 Hole Avenue, 106, Riverside, CA 92505 | 2011-12-29 |
| Find all providers in zip 92505 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477997336 | Aras Emdadi | Surgery | 7300 Magnolia Ave # Surgery, Riverside, CA 92504-3849 | 2013-04-23 |
| 1639497209 | Benjamin Y Leong Md Inc | Surgery | 4000 14th St Ste 412, Riverside, CA 92501-4010 | 2010-05-06 |
| 1457675001 | David R Barton | Surgery | 13945 Harvey Ln, Riverside, CA 92503-7263 | 2010-03-24 |
| 1508012576 | Thorocor Medical Enterprises, Inc. | Surgery | 3903 Brockton Ave, Suite Two, Riverside, CA 92501-3212 | 2008-08-11 |
| 1154577328 | Shaun C Daly | Surgery | 3600 Park Sierra Dr Ste 105, Riverside, CA 92505-3059 | 2008-08-07 |
| 1588849152 | Emergency Surgical Associates | Surgery | 3903 Brockton Ave Ste 1, Riverside, CA 92501-3212 | 2008-01-02 |
| 1437344538 | So. Cal. Endo Surgical Medical Group, Inc. | Surgery | 3838 Sherman Dr Ste 6, Riverside, CA 92503-4001 | 2007-09-11 |
| 1932329265 | Mark Laverne Janzen | Surgery | 10800 Magnolia Avenue, Kaiser Permanente Riverside Medical Center, Riverside, CA 92505 | 2007-04-27 |
| 1770659278 | Harvey Nurick M.d. Incorporated | Surgery | 7111 Indiana Ave # 100, Riverside, CA 92504-4543 | 2006-11-27 |
| 1063423093 | Colathur K Palani | Surgery | 3412 Harlem Ave, Riverside, IL 60546-2365 | 2006-08-11 |
| Find all providers in RIVERSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.