Misson OB/GYN Medical Group, Inc.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

MISSON OB/GYN MEDICAL GROUP, INC.

Practice address

26800 Crown Valley Parkway
Suite 525
Mission Viejo, CA 92691-8029

Phone

(949) 364-1040

Fax

(949) 365-7037

NPI assigned

Sep 13, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kurt D Miller, MD

Title

C.E.O

Phone

(949) 364-1040

Specialties & licenses 1

Addresses

Other identifiers 1

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268006400000",
    "number": "1013012244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PARKWAY",
            "address_2": "SUITE 525",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918029",
            "telephone_number": "949-364-1040",
            "fax_number": "949-365-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PARKWAY",
            "address_2": "SUITE 525",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918029",
            "telephone_number": "949-364-1040",
            "fax_number": "949-365-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSON OB/GYN MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2010-03-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "949-364-1040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GROO71230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mission Viejo Endoscopy Partners, LLC
• Mission Viejo Family Medical Center
• Mission Viejo Modern Dentistry, Prof. Corp.
• Mission Viejo Office
• Mission Viejo Radiation Oncology Corp.
• Sean Mitchell, LMFT
• Madonna Victor Fawzi Mitri
• Michael I Miyamoto, M.D.
• Talah Moaddab
• Gregory Moe

• Obstetrics & Gynecology Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.