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General NPI Number Information
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NPI Number | 1811737992
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Entity Type | Organization
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Legal Business Name | MISSION PREP HEALTHCARE
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Dates
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Enumeration Date | 05/28/2024
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 7046 VIA DE LA REINA
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City | BONSALL
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State | CA
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Zip | 92003-6400
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Country | US
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Telephone | 833-589-5150
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Fax | 949-579-2876
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Provider Business Mailing Address
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Address Line | 30310 RANCHO VIEJO RD
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-1576
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | JEFFREY FARBMAN
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Credential |
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Telephone | 949-301-2863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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