Healthcare Provider Details

I. General information

NPI: 1710374715
Provider Name (Legal Business Name): MISSION HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27700 MEDICAL CENTER RD
MISSION VIEJO CA
92691-6426
US

IV. Provider business mailing address

3345 MICHELSON DR
IRVINE CA
92612-0692
US

V. Phone/Fax

Practice location:
  • Phone: 949-364-1400
  • Fax:
Mailing address:
  • Phone: 949-381-4122
  • Fax: 714-704-6840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: RAMIRO GONZAEZ
Title or Position: SYSTEM ADMISTRATOR
Credential:
Phone: 949-381-4122