Basic Information
| Provider Information | |||||||||
| NPI: | 1902978562 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MISSION MEDICAL URGENT CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26800 CROWN VALLEY PKWY | ||||||||
| Address2: | STE 150 | ||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926918018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9492762111 | ||||||||
| FaxNumber: | 9492762116 | ||||||||
| Practice Location | |||||||||
| Address1: | 26800 CROWN VALLEY PKWY | ||||||||
| Address2: | STE 150 | ||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92691 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9492762111 | ||||||||
| FaxNumber: | 9492762116 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2006 | ||||||||
| LastUpdateDate: | 01/29/2014 | ||||||||
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| AuthorizedOfficialLastName: | CZULEGER | ||||||||
| AuthorizedOfficialFirstName: | PETER | ||||||||
| AuthorizedOfficialMiddleName: | CRAIG | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER / M.D | ||||||||
| AuthorizedOfficialTelephone: | 9492762111 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | A34446 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.