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General NPI Number Information
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NPI Number | 1174749295
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Entity Type | Organization
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Legal Business Name | MISSION MEDICAL CARE OF SOUTHERN CALIFORNIA
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 300 W 5TH ST SUITE C
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City | OXNARD
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State | CA
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Zip | 93030-0000
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Country | US
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Telephone | 805-247-1811
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Fax | 805-483-7981
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Provider Business Mailing Address
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Address Line | 300 W 5TH ST SUITE C
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City | OXNARD
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State | CA
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Zip | 93030-0000
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Country | US
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Telephone | 805-247-1811
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Fax | 805-483-7981
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. ADRIAN ROJAS
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Credential | PAC
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Telephone | 805-247-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A67969
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License Number State | CA
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