Provider Demographics
NPI:1225093305
Name:MISSION HILLS MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:MISSION HILLS MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MON-TA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-588-0051
Mailing Address - Street 1:25982 PALA
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6730
Mailing Address - Country:US
Mailing Address - Phone:949-588-0051
Mailing Address - Fax:949-588-0052
Practice Address - Street 1:25982 PALA
Practice Address - Street 2:SUITE 250
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6730
Practice Address - Country:US
Practice Address - Phone:949-588-0051
Practice Address - Fax:949-588-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19223Medicare ID - Type Unspecified