Organization
MISSION OB/GYN MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KURT D MILLER MD (CEO)
(949) 364-1040
Entity
Organization
Contact information
Practice address
665 CAMINO DE LOS MARES, STE 303-A, SAN CLEMENTE, CA 92673-2859
(949) 364-1040
(949) 365-7037
Mailing address
26800 CROWN VALLEY PKWY, STE 525, MISSION VIEJO, CA 92691-6384
(949) 364-1040
(949) 365-7037
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0071231
—
CA
Enumeration date
09/13/2006
Last updated
10/11/2012
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