Mira Mesa Business Group LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

MIRA MESA BUSINESS GROUP LLC

Practice address

9460 Mira Mesa Blvd
Suite L
San Diego, CA 92126-4851

Phone

(858) 863-7246

Fax

(858) 252-2650

NPI assigned

Feb 1, 2017

Organization subpart

No

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

Authorized official

Name

Davis Duong

Title

Secretary

Phone

(858) 380-7530

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485907200000",
    "number": "1750829487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9460 MIRA MESA BLVD",
            "address_2": "SUITE L",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264851",
            "telephone_number": "858-863-7246",
            "fax_number": "858-252-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9460 MIRA MESA BLVD",
            "address_2": "SUITE L",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264851",
            "telephone_number": "858-863-7246",
            "fax_number": "858-252-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRA MESA BUSINESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-02-01",
        "status": "A",
        "authorized_official_last_name": "DUONG",
        "authorized_official_first_name": "DAVIS",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "858-380-7530"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Minty
• Tasha Ingrid Mintzer, DACM, L.AC.
• Joshua James Minuto, M.D.
• Todd Michael Miodek, NP
• Mikael Mir, MD
• Mira Mesa Chiropractic
• Mira Mesa Dental & Orthodontic Office
• Mira Mesa Optometry, Inc
• Melanie Mira
• Cynthia Marie Miracle, MD

• Physical Medicine & Rehabilitation Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.