MEDICARE: MISURGICAL MULTISPECIALTY MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	207L00000X	Anesthesiology Physician
3	207LP2900X	Pain Medicine (Anesthesiology) Physician
4	207X00000X	Orthopaedic Surgery Physician
5	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician
6	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1609726751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISURGICAL MULTISPECIALTY MEDICAL GROUP

Provider Business Mailing Address
First Line	:	29300 PORTOLA PKWY STE B
Second Line	:
City	:	LAKE FOREST
State	:	CA
Zip	:	92630-8741
Country	:	US
Telephone Number	:	949-916-3134
Fax Number	:	949-612-0857

Provider Business Practice Location Address
First Line	:	29300 PORTOLA PKWY STE B
Second Line	:
City	:	LAKE FOREST
State	:	CA
Zip	:	92630-8741
Country	:	US
Telephone Number	:	949-916-3134
Fax Number	:	949-612-0857

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	AFZAAL IQBAL
Credential	:	MD
Telephone Number	:	949-916-3134

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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