Organization Active NPI

Gubbi T Mruthyunjaya

  • Primary Care Clinic/Center
  • Mission Viejo, CA
National Provider Identifier
1558639815
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
A24744 Issued in CA
Legal business name
GUBBI T MRUTHYUNJAYA
Practice address
27800 Medical Center Rd
Suite 300
Mission Viejo, CA 92691-6049
Phone
(949) 364-2229
Fax
(949) 364-1104
NPI assigned
Dec 1, 2011
Last updated
Dec 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Authorized official

Name
Alejandra Cornejo
Title
Biller
Phone
(949) 364-2229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X A24744 CA Primary

Addresses

Primary practice location

27800 Medical Center Rd
Suite 300
Mission Viejo, CA 92691-6049

Mailing address

27800 Medical Center Rd
Suite 300
Mission Viejo, CA 92691-6049
Phone (949) 364-2229

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1558639815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD",
            "address_2": "SUITE 300",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916049",
            "telephone_number": "949-364-2229",
            "fax_number": "949-364-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD",
            "address_2": "SUITE 300",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916049",
            "telephone_number": "949-364-2229",
            "fax_number": "949-364-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUBBI T MRUTHYUNJAYA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "CORNEJO",
        "authorized_official_first_name": "ALEJANDRA",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "949-364-2229"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A24744",
            "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 Dec 19, 2011; 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.