Mission Surgical Clinic, Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G56529 Issued in CA

Legal business name

MISSION SURGICAL CLINIC, INC.

Practice address

7300 Magnolia Ave
Riverside, CA 92504-3849

Phone

(951) 278-8870

Fax

(951) 278-8913

NPI assigned

May 8, 2006

Last updated

Dec 28, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael S. Chin, M.D.NPI 1114012648

Title

President

Phone

(951) 278-8870

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Sywe-Yung Chin, M.D.

  • Surgery Physician
  • Riverside, CA
  • NPI 1114012648
  Medicare reassignment Care Compare group NPD Authorized official
• Benjamin Fegale, MD

  • Vascular Surgery Physician
  • Riverside, CA
  • NPI 1972982239
  Medicare reassignment Care Compare group NPD
• Vincent Reginald Favor Narvaez, M.D.

  • Vascular Surgery Physician
  • Riverside, CA
  • NPI 1053843862
  Medicare reassignment Care Compare group NPD
• Arash Atabak Rahimi-Ardabily

  • Surgery Physician
  • Riverside, CA
  • NPI 1770044299
  Medicare reassignment Care Compare group NPD
• Francisco Vega, M.D.

  • Vascular Surgery Physician
  • Riverside, CA
  • NPI 1538422704
  Medicare reassignment Care Compare group NPD
• James A. Pollack, M.D.

  • Surgery Physician
  • Riverside, CA
  • NPI 1205845807
  Medicare reassignment Care Compare group
• Sam Seunghae Ahn, MD

  • Vascular Surgery Physician
  • Los Angeles, CA
  • NPI 1497783831
  Medicare reassignment NPD
• Massimo Arcerito, MD

  • Surgery Physician
  • Corona, CA
  • NPI 1023200409
  Medicare reassignment NPD
• Anthony Hung Chau, M.D.

  • Vascular Surgery Physician
  • Orange, CA
  • NPI 1699055988
  Medicare reassignment NPD
• Mathew Cheung, D.O.

  • Surgery Physician
  • Arcadia, CA
  • NPI 1417251026
  Medicare reassignment NPD
• Randall Cornateanu, M.D.

  • Surgery Physician
  • Placentia, CA
  • NPI 1043606429
  Medicare reassignment NPD
• Shaun C Daly, M.D.

  • Surgery Physician
  • Orange, CA
  • NPI 1154577328
  Medicare reassignment NPD

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640649600000",
    "number": "1457300436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2828",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928782828",
            "telephone_number": "951-278-8870",
            "fax_number": "951-278-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043849",
            "telephone_number": "951-278-8870",
            "fax_number": "951-278-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION SURGICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "CHIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-278-8870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA16804",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G56529",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "20A10803",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G75730",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "20A9434",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G565290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mission Inn Senior Living LLC (The Grove Assisted Living)
• Mission Lake Chiropractic Center
• Mission Medical Associates, Inc.
• Mission Medical Clinic
• Mission Surgical Center Inc
• Mission Surgical Group
• Mission Urology, Inc. (Mission Urology)
• Felicia A Mitchell Payton, LMFT
• Amber Mitchell, CHW
• Barbara Jean Mitchell, LCSW

• Surgery Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.