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General NPI Number Information
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NPI Number | 1972425585
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Entity Type | Organization
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Legal Business Name | MITOCHONDRIAL MEDICINE, INC.
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 33872 AVENIDA CALITA
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-4942
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Country | US
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Telephone | 949-226-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 33959 DOHENY PARK RD # 1018
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-4835
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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 | OWNER/PROVIDER
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Name | DR. MICHAEL HAGA
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Credential | MD
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Telephone | 949-226-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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