Mission Pathology Medical Associates

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D0903813 Issued in CA

Legal business name

MISSION PATHOLOGY MEDICAL ASSOCIATES

Practice address

27700 Medical Center Rd
Mission Viejo, CA 92691-6426

Phone

(949) 364-1400

NPI assigned

Aug 21, 2006

Organization subpart

No

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

Authorized official

Name

Justin Ekuan, M.D.

Title

President

Phone

(949) 364-1400

Specialties & licenses 1

Addresses

Other identifiers 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

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238457600000",
    "number": "1649386913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27700 MEDICAL CENTER RD",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916426",
            "telephone_number": "949-364-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27700 MEDICAL CENTER RD",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916426",
            "telephone_number": "949-364-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION PATHOLOGY MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2009-03-31",
        "status": "A",
        "authorized_official_last_name": "EKUAN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-364-1400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D0903813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0014030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mission Internal Medical Froup, Inc.
• Mission Internal Medical Group, Inc.
• Mission Internal Medical Group, Inc.
• Mission Internal Medical Group, Inc.
• Mission Medical Urgent Care
• Mission Pediatric Dentistry
• Mission Pediatric Med CL
• Mission Pediatric Medical Clinic, Inc.
• Mission Toxicology, LLC
• Mission Trauma Surgical Medical GRP

• Clinical Medical Laboratory in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.