Mission Viejo Medical Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

C27618 Issued in CA

Legal business name

MISSION VIEJO MEDICAL CLINIC

Doing business as

Laguna Niguel Family Medical Center

Practice address

30110 Crown Valley Pkwy
Laguna Niguel, CA 92677-2043

Phone

(949) 496-3013

Fax

(949) 495-0270

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

William Francis Lyon, M. D.

Title

President

Phone

(949) 495-7144

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Laguna Niguel Family Medical Center Doing business as

Locations

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188000000000",
    "number": "1770653289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30110 CROWN VALLEY PKWY",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772043",
            "telephone_number": "949-496-3013",
            "fax_number": "949-495-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30110 CROWN VALLEY PKWY",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772043",
            "telephone_number": "949-496-3013",
            "fax_number": "949-495-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION VIEJO MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-08-25",
        "status": "A",
        "authorized_official_last_name": "LYON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-495-7144",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "C27618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C276180",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "C27618",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ12501Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laguna Niguel Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Milomir Milosevich, PT
• Rachel Elizabeth Minahan, OTR
• Tricia Minty
• Miracor Diagnostics, Inc.
• Mission Internal Medical Group, Inc.
• Mission Viejo Radiology Center, Inc.
• Steven Mitchell, ASW
• Melika Moeini, DMD
• Tannaz Moghim Dehkordi
• Pegah Mohtashemi

• Clinic/Center in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2007; 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.