Provider Demographics
NPI:1164534400
Name:MISSION HILLS SURGICENTER, LLC
Entity Type:Organization
Organization Name:MISSION HILLS SURGICENTER, LLC
Other - Org Name:MISSION HILLS PAIN TREATMENT CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AFSHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GERAYLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-297-3838
Mailing Address - Street 1:25982 PALA
Mailing Address - Street 2:SUITE#280
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6719
Mailing Address - Country:US
Mailing Address - Phone:949-297-3838
Mailing Address - Fax:949-297-3839
Practice Address - Street 1:25982 PALA
Practice Address - Street 2:SUITE#280
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6719
Practice Address - Country:US
Practice Address - Phone:949-297-3838
Practice Address - Fax:949-297-3839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAS051767261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051767OtherMEDICARE ID