Organization
MISSION VIEJO FAMILY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID SCOT ZIMMERMAN M.D. (PRESIDENT)
(949) 588-8775
Entity
Organization
Contact information
Practice address
27001 LA PAZ RD, SUITE #294, MISSION VIEJO, CA 92691-5502
(949) 588-8775
(949) 588-9005
Mailing address
27001 LA PAZ RD, SUITE #294, MISSION VIEJO, CA 92691-5502
(949) 588-8775
(949) 588-9005
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A44517
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0042990
—
CA
01
—
ZZZ06326Z
BLUE SHIELD OF CA
CA
Enumeration date
11/16/2006
Last updated
08/21/2008
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