# MISSION MEDICAL ASSOCIATES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609193705
- **Authorized official:** RANDOLPH TAYLOR (SECRETARY)
- **Authorized official phone:** (949) 870-3617

## Contact information

- **Practice address:** 6276 RIVER CREST DR, RIVERSIDE, CA 92507-0783
- **Practice address phone:** (951) 413-0979
- **Mailing address:** 20377 SW ACACIA ST STE 110, ATTN: R TAYLOR, NEWPORT BEACH, CA 92660-0781
- **Mailing address phone:** (949) 870-3617

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/28/2010
- **Last updated:** 04/28/2010