Mirage Center Outpatient Surgery

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

Legal business name

MIRAGE CENTER OUTPATIENT SURGERY

Practice address

39935 Vista del Sol Ste 101
Rancho Mirage, CA 92270-3211

Phone

(760) 413-8182

NPI assigned

Jun 24, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Justyn Mawby

Title

Admin/Or Supervisor

Phone

(760) 485-9636

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1245128917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39935 VISTA DEL SOL STE 206",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703211",
            "telephone_number": "760-413-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39935 VISTA DEL SOL STE 101",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703211",
            "telephone_number": "760-413-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRAGE CENTER OUTPATIENT SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "MAWBY",
        "authorized_official_first_name": "JUSTYN",
        "authorized_official_title_or_position": "ADMIN/OR SUPERVISOR",
        "authorized_official_telephone_number": "760-485-9636",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan R Minkoff, DO
• Ranjeet Minocha, M.D.
• Mirage Aesthetic Concepts Surgical Center
• Mirage Ambulatory Surgery Center, Inc
• Mirage Care LLC
• Mirage Endoscopy Center, L.P.
• Mirage Medical Group
• Mirage on Call Medical Group Inc
• Mirage Pain and Rehabilitation Associates a Medical Group Inc
• Mirage Pain and Rehabilitation Associates a Medical Group, Inc.

• Oral & Maxillofacial Surgery (D.M.D.) in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.