Organization Active NPI

Mission Children'S Medical Group, Inc

  • Pediatrics Physician
  • Mission Viejo, CA
National Provider Identifier
1124123096
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MISSION CHILDREN'S MEDICAL GROUP, INC
Practice address
26732 Crown Valley Pkwy
Ste 571
Mission Viejo, CA 92691-6306
Phone
(949) 364-8700
Fax
(949) 365-1011
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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
Ceo
Phone
(949) 364-8700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

26732 Crown Valley Pkwy
Ste 571
Mission Viejo, CA 92691-6306

Mailing address

26732 Crown Valley Pkwy
Ste 571
Mission Viejo, CA 92691-6306
Phone (949) 364-8700

National Provider Directory

National Provider Directory

Locations

26732 Crown Valley Pkwy
Ste 571
Mission Viejo, CA 92691
Phone (949) 229-1441

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124123096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PKWY",
            "address_2": "STE 571",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916306",
            "telephone_number": "949-364-8700",
            "fax_number": "949-365-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PKWY",
            "address_2": "STE 571",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916306",
            "telephone_number": "949-364-8700",
            "fax_number": "949-365-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION CHILDREN'S MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-364-8700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.