Provider Demographics
NPI:1326425596
Name:MINIMALLY INVASIVE SURGICAL INSTITUTE LLC
Entity Type:Organization
Organization Name:MINIMALLY INVASIVE SURGICAL INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAZLI
Authorized Official - Middle Name:
Authorized Official - Last Name:AREFKIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-484-7222
Mailing Address - Street 1:26921 CROWN VALLEY PKWY
Mailing Address - Street 2:120
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6501
Mailing Address - Country:US
Mailing Address - Phone:949-484-7222
Mailing Address - Fax:
Practice Address - Street 1:26921 CROWN VALLEY PKWY
Practice Address - Street 2:110
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6501
Practice Address - Country:US
Practice Address - Phone:949-484-7222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical