Organization
MISSION PATHOLOGY MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN EKUAN M.D. (PRESIDENT)
(949) 364-1400
Entity
Organization
Contact information
Practice address
27700 MEDICAL CENTER RD, MISSION VIEJO, CA 92691-6426
(949) 364-1400
Mailing address
27700 MEDICAL CENTER RD, MISSION VIEJO, CA 92691-6426
(949) 364-1400
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D0903813
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0014030
—
CA
Enumeration date
08/21/2006
Last updated
03/31/2009
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