MISSION SURGICAL GROUP (NPI# 1780037432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780037432 |
| Entity Type | Organization |
| Organization Name | MISSION SURGICAL GROUP |
| Practice Address |
36243 Inland Valley Dr Suite 280 Wildomar CA 92595-9549 |
| Mailing Address |
Po Box 512347 Los Angeles CA 90051-0347 |
| Practice Telephone | 9512788870 |
| Practice Fax Number | 9512788913 |
| Mailing Telephone | 7144563856 |
| Mailing Fax Number | 7144566216 |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |
| Authorized Official Name | DR. MANUEL PORTO (PRESIDENT) |
| Authorized Official Telephone | 7144562986 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | REGENTS OF THE UNIVERSITY OF CALIFORNIA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205289956 | Mission Surgical Group | Clinic/Center | 2250 S Main St, Suite 206, Corona, CA 92882-2534 | 2016-07-18 |
| 1104276393 | Mission Surgical Group | Clinic/Center | 3660 Park Sierra Dr, Riverside, CA 92505-3081 | 2016-06-17 |
| Street Address |
36243 INLAND VALLEY DR SUITE 280 |
| City | WILDOMAR |
| State | CA |
| Zip Code | 92595-9549 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962405142 | Mohammad Kaleem Uddin | Neurological Surgery | 36243 Inland Valley Dr, Ste 210, Wildomar, CA 92595-9549 | 2005-05-23 |
| 1063074904 | Jaelynne Michelle Allen | Nurse Practitioner | 36243 Inland Valley Dr, Wildomar, CA 92595-9549 | 2019-07-01 |
| 1013373398 | Danielle Merchant Martin | Nurse Practitioner | 36243 Inland Valley Dr, Wildomar, CA 92595-9549 | 2016-01-03 |
| 1386064624 | Rochester Imperial Surgical Center LLC | Clinic/Center | 36243 Inland Valley Dr, Ste 10, Wildomar, CA 92595-9549 | 2014-04-25 |
| 1992125231 | Kensington Diagnostics LLC | Clinical Medical Laboratory | 36243 Inland Valley Dr, Ste 10, Wildomar, CA 92595-9549 | 2014-04-25 |
| 1235431172 | Inscriptions Children's Clinic | Clinic/Center | 36243 Inland Valley Dr, Suite #80, Wildomar, CA 92595-9549 | 2010-11-29 |
| 1043445208 | Reliance Best Pharmacy LLC | Pharmacy | 36243 Inland Valley Dr, #130, Wildomar, CA 92595-9549 | 2009-05-18 |
| 1801088869 | Joan Amador | Marriage & Family Therapist | 36243 Inland Valley Dr, Suite 50, Wildomar, CA 92595-9549 | 2007-08-14 |
| 1154467561 | Abdul S. Farzin M.d., Inc | Family Medicine | 36243 Inland Valley Dr, Suite 240, Wildomar, CA 92595-9549 | 2007-01-30 |
| 1053465625 | Carmeleene Suarez Baguio | Registered Nurse | 36243 Inland Valley Dr, 110, Wildomar, CA 92595-9549 | 2007-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184190845 | Amber Nicole Salgado | Licensed Vocational Nurse | 33685 Harvest Way East, Wildomar, CA 92595 | 2018-10-22 |
| 1417448168 | Inland Valley Trauma and Acute Care Surgery Apc Inc | Surgery | 36320 Inland Valley Dr Ste 101a, Wildomar, CA 92595 | 2018-05-29 |
| 1033636311 | Omar H Nael | Behavioral Analyst | 35925 Susan Dr, Wildomar, CA 92595 | 2017-08-27 |
| 1023535820 | Dennis Bonavilla | Specialist/Technologist, Other | 34859 Frederick Street, Suite 112, Wildomar, CA 92595 | 2017-08-23 |
| 1578965901 | Purnima K Patel M.d Inc | Internal Medicine | 32423 Inland Valley Dr. Ste 160, Wildomar, CA 92595 | 2014-09-17 |
| 1740523133 | Jerry Zhong Yu | Internal Medicine | 36320 Inland Valley Dr Ste 308, Wildomar, CA 92595 | 2013-04-03 |
| 1871859553 | Norman Orr | Internal Medicine | 36485 Valley Medical Center, Wildomar, CA 92595 | 2012-04-06 |
| 1902190226 | Brian Patrick Tiu | Surgery | 36320 Inland Valley Dr Ste 101, Wildomar, CA 92595 | 2011-06-03 |
| 1508013897 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 24335 Prielipp Rd Bldg A, Ste 116, Wildomar, CA 92595 | 2008-08-19 |
| 1760604383 | Nasko Lubenov Atanassov | Physical Therapist | 36485 Inland Valey Drive, Wildomar, CA 92595 | 2007-05-03 |
| Find all providers in zip 92595 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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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.