Provider Demographics
NPI:1275603490
Name:MISSION SURGICAL, INC.
Entity Type:Organization
Organization Name:MISSION SURGICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACE
Authorized Official - Middle Name:
Authorized Official - Last Name:HELMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-492-1023
Mailing Address - Street 1:PO BOX 130416
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92013-0416
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7950 DUNBROOK RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4371
Practice Address - Country:US
Practice Address - Phone:858-621-5959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0180680001Medicare PIN