# MISSION SURGICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** REGENTS OF THE UNIVERSITY OF CALIFORNIA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104276393
- **Legal business name:** REGENTS OF THE UNIVERSITY OF CALIFORNIA
- **Authorized official:** DR. MANUEL PORTO M.D. (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (714) 456-8721

## Contact information

- **Practice address:** 3660 PARK SIERRA DR, RIVERSIDE, CA 92505-3081
- **Practice address phone:** (951) 278-8870
- **Practice address fax:** (951) 278-8913
- **Mailing address:** 200 S MANCHESTER AVE, SUITE \#315, ORANGE, CA 92868-3217
- **Mailing address phone:** (714) 456-2986
- **Mailing address fax:** (714) 456-8351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/17/2016
- **Last updated:** 06/17/2016