Organization
MISSION INTERNAL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS WOLIN (CEO)
(949) 282-1600
Entity
Organization
Contact information
Practice address
26800 CROWN VALLEY PKWY, #100, MISSION VIEJO, CA 92691-6306
(949) 364-6000
(949) 364-9561
Mailing address
26522 LA ALAMEDA, SUITE 120, MISSION VIEJO, CA 92691-6330
(949) 282-1600
(949) 367-0518
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0089532
—
CA
05
—
ZZZ71959Z
—
CA
Enumeration date
01/06/2006
Last updated
05/24/2010
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