Healthcare Provider Details

I. General information

NPI: 1164534400
Provider Name (Legal Business Name): MISSION HILLS SURGICENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25982 PALA SUITE#280
MISSION VIEJO CA
92691-6719
US

IV. Provider business mailing address

25982 PALA STE 280
MISSION VIEJO CA
92691-6729
US

V. Phone/Fax

Practice location:
  • Phone: 949-297-3838
  • Fax: 949-297-3839
Mailing address:
  • Phone: 949-297-3838
  • Fax: 949-297-3839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberS051767
License Number StateCA

VIII. Authorized Official

Name: ANNA GERAYLI
Title or Position: ADMINISTRATOR
Credential:
Phone: 949-230-5776