NPIMap

Organization Active NPI

Mission Internal Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Mission Viejo, CA
National Provider Identifier
1902884174
Registry record updated May 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MISSION INTERNAL MEDICAL GROUP, INC.
Practice address
26800 Crown Valley Pkwy
#100
Mission Viejo, CA 92691-6306
Phone
(949) 364-6000
Fax
(949) 364-9561
NPI assigned
Jan 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2010

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

Authorized official

Name
Mr. Dennis Wolin
Title
Ceo
Phone
(949) 282-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

26800 Crown Valley Pkwy
#100
Mission Viejo, CA 92691-6306

Mailing address

26522 La Alameda
Suite 120
Mission Viejo, CA 92691-6330
Phone (949) 282-1600

Other identifiers 2

IdentifierTypeStateIssuer
GR0089532MedicaidCA
ZZZ71959ZMedicaidCA

National Provider Directory

National Provider Directory

Locations

23961 Calle de la Magdalena
Ste 232
Laguna Hills, CA 92653

24411 Health Center Dr
Ste 650
Laguna Hills, CA 92653
Phone (949) 364-0644

27882 Forbes Rd
Ste 110
Laguna Niguel, CA 92677
Phone (949) 364-2955

27800 Medical Center Rd
Ste 210
Mission Viejo, CA 92691
Phone (714) 837-9610

26732 Crown Valley Pkwy
Ste 131
Mission Viejo, CA 92691

27800 Medical Center Rd
Ste 202
Mission Viejo, CA 92691
Phone (714) 364-5119

27451 Los Altos
Ste 100
Mission Viejo, CA 92691

22032 El Paseo
Ste 140
Rcho Sta Marg, CA 92688
Phone (949) 766-8505

665 Camino de los Mares
Ste 208
San Clemente, CA 92673
Phone (714) 466-0787

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274659200000",
    "number": "1902884174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26522 LA ALAMEDA",
            "address_2": "SUITE 120",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916330",
            "telephone_number": "949-282-1600",
            "fax_number": "949-367-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY",
            "address_2": "#100",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916306",
            "telephone_number": "949-364-6000",
            "fax_number": "949-364-9561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION INTERNAL MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-06",
        "last_updated": "2010-05-24",
        "status": "A",
        "authorized_official_last_name": "WOLIN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-282-1600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0089532",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ71959Z",
            "state": "CA"
        }
    ],
    "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 May 24, 2010; 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.