Provider Demographics
NPI:1710374715
Name:MISSION HOSPITAL
Entity Type:Organization
Organization Name:MISSION HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SYSTEM ADMISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAMIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-381-4122
Mailing Address - Street 1:3345 MICHELSON DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-0692
Mailing Address - Country:US
Mailing Address - Phone:949-381-4122
Mailing Address - Fax:714-704-6840
Practice Address - Street 1:27700 MEDICAL CENTER RD
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6426
Practice Address - Country:US
Practice Address - Phone:949-364-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1093945412Medicare Oscar/Certification