Organization · NPI-2

Mission Center For Longevity & Aesthetic Medicine

Internal Medicine · Mission Viejo, CA

NPI number1740418680
StatusActive
Last updated in NPPESJun 30, 2009

Details

NPI
1740418680
Entity type
Organization (NPI-2)
Legal business name
Mission Center For Longevity & Aesthetic Medicine
Organization subpart
No
Enumeration date
Jun 30, 2009
Last updated
Jun 30, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineA64307CAYes
207R00000X Internal MedicineG69073CA
207YX0905X Otolaryngology, Otolaryngology/Facial Plastic SurgeryG66486CA

Practice location

26730 Crown Valley Pkwy Ste 250
Mission Viejo, CA 92691-8000

Phone 949-364-2440 · Fax 949-364-2778

Mailing address

26730 Crown Valley Pkwy Ste 250
Mission Viejo, CA 92691-8000

Phone 949-364-2440 · Fax 949-364-2778

Authorized official

James Alan Heinrich
President Of The Board
9493642440

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Internal Medicine providers in Mission Viejo, CA