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General NPI Number Information
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NPI Number | 1609726751
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Entity Type | Organization
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Legal Business Name | MISURGICAL MULTISPECIALTY MEDICAL GROUP
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 29300 PORTOLA PKWY STE B
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City | LAKE FOREST
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State | CA
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Zip | 92630-8741
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Country | US
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Telephone | 949-916-3134
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Fax | 949-612-0857
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Provider Business Mailing Address
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Address Line | 29300 PORTOLA PKWY STE B
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City | LAKE FOREST
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State | CA
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Zip | 92630-8741
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Country | US
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Telephone | 949-916-3134
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Fax | 949-612-0857
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | AFZAAL IQBAL
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Credential | MD
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Telephone | 949-916-3134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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