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Organization
MISSION MEDICAL ASSOCIATES, INC.
Active
Organization
MISSION MEDICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDOLPH TAYLOR (SECRETARY)
(949) 870-3617
Entity
Organization
Contact information
Practice address
6276 RIVER CREST DR, RIVERSIDE, CA 92507-0783
(951) 413-0979
Mailing address
20377 SW ACACIA ST STE 110, ATTN: R TAYLOR, NEWPORT BEACH, CA 92660-0781
(949) 870-3617
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
04/28/2010
Last updated
04/28/2010
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