Mission Pediatric Med CL

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

Legal business name

MISSION PEDIATRIC MED CL

Practice address

27800 Medical Center Rd
Ste 116
Mission Viejo, CA 92691-6410

Phone

(949) 364-6040

Fax

(949) 364-0502

NPI assigned

Jan 30, 2012

Organization subpart

No

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

Authorized official

Name

Duke D Kim, M.D.NPI 1780690636

Title

President

Phone

(949) 364-6040

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Mission Pediatric Med CL2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mission Pediatric Medical Clinic, Inc.

  • Pediatrics Physician
  • Mission Viejo, CA
  • NPI 1538234646
  NPD tax ID

Locations

Practitioners 1

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

• Duke D Kim, MD

  • Pediatric Allergy/Immunology Physician
  • Mission Viejo, CA
  • NPI 1780690636
  NPD Authorized official

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556236800000",
    "number": "1124390679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD",
            "address_2": "STE 116",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916410",
            "telephone_number": "949-364-6040",
            "fax_number": "949-364-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD",
            "address_2": "STE 116",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916410",
            "telephone_number": "949-364-6040",
            "fax_number": "949-364-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION PEDIATRIC MED CL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2019-04-26",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DUKE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-364-6040",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1780690636",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mission Internal Medical Group, Inc.
• Mission Internal Medical Group, Inc.
• Mission Medical Urgent Care
• Mission Pathology Medical Associates
• Mission Pediatric Dentistry
• Mission Pediatric Medical Clinic, Inc.
• Mission Toxicology, LLC
• Mission Trauma Surgical Medical GRP
• Mission Viejo Assisted Living LLC
• Mission Viejo Dental Associates

• Allergy & Immunology Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Allergy & Immunology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; 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.