Mission Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

200901610039 Issued in CA

Legal business name

MISSION MEDICAL SUPPLY

Practice address

4444 El Cajon Blvd
03
San Diego, CA 92115-4312

Phone

(619) 229-9597

Fax

(619) 229-9594

NPI assigned

Aug 5, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Mimi DO

Title

Owner

Phone

(619) 229-9597

Specialties & licenses 1

Addresses

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.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345507200000",
    "number": "1881825008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 EL CAJON BLVD",
            "address_2": "03",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154312",
            "telephone_number": "619-229-9597",
            "fax_number": "619-229-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 EL CAJON BLVD",
            "address_2": "03",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154312",
            "telephone_number": "619-229-9597",
            "fax_number": "619-229-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-05",
        "last_updated": "2012-08-21",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "MIMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-229-9597",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "200901610039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mission Hills Physical Therapy
• Mission Home Health of Rancho Mirage LLC
• Mission Home Health of San Diego LLC
• Mission Hospice Services of San Diego, LLC
• Mission Medical Group of the Inland Empire
• Mission Medical Transport
• Mission Occupational and Hand Therapy Services Apc
• Mission Palm'S Transportation LLC
• Mission Pharmacy & Compounding, LTD
• Mission Psychological Services, Inc

• Durable Medical Equipment & Medical Supplies in San Diego, CA
• Providers in San Diego, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; 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.