Mission Avenue Medical Associates

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MISSION AVENUE MEDICAL ASSOCIATES

Practice address

3625 Mission Ave Ste D
Carmichael, CA 95608-2954

Phone

(916) 486-1906

Fax

(916) 486-9566

NPI assigned

Jul 30, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Richard G Slechta Jr.

Title

Office Manager

Phone

(916) 601-4513

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532908800000",
    "number": "1275011546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 MISSION AVE STE D",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956082954",
            "telephone_number": "916-486-1906",
            "fax_number": "916-486-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 MISSION AVE STE D",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956082954",
            "telephone_number": "916-486-1906",
            "fax_number": "916-486-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION AVENUE MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A",
        "authorized_official_last_name": "SLECHTA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "916-601-4513",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Paul Miller, MD
• Vicki Lynn Miller, LAADC, CADCII
• Aimee Mills-Erler
• Siriwan Mingbunjerdsuk, M.D.
• Denise Nicole Mio- Cunningham, ASW
• Mission Carmichael Post Acute LLC
• Mission Peak Holdings, LLC.
• Mitchell E Blum MD Inc
• Cheryl Mitchell, PA
• Paul Lamont Mitchell

• Primary Care Clinic/Center in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.