Organization
MISSION SURGICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S. CHIN M.D. (PRESIDENT)
(951) 278-8870
Entity
Organization
Contact information
Practice address
7300 MAGNOLIA AVE, RIVERSIDE, CA 92504-3849
(951) 278-8870
(951) 278-8913
Mailing address
PO BOX 2828, CORONA, CA 92878-2828
(951) 278-8870
(951) 278-8913
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
20A10803
CA
208600000X
Surgery Physician
20A9434
CA
208600000X
Surgery Physician
Primary
G56529
CA
208600000X
Surgery Physician
G75730
CA
363AS0400X
Surgical Physician Assistant
PA16804
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G565290
—
CA
Enumeration date
05/08/2006
Last updated
12/28/2021
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