| Our Mission Medical Clinic | |
|
1811 W Katella Ave Ste 117 Anaheim CA 92804-6657 | |
| (657) 220-4208 | |
| (714) 333-4980 |
| Full Name | Our Mission Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1811 W Katella Ave Ste 117, Anaheim, California |
| Authorized Official Name and Position | Emma Bacani (CFO) |
| Authorized Official Contact | 6268070401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Our Mission Medical Clinic 1811 W Katella Ave Ste 117 Anaheim CA 92804-6657 Ph: (657) 220-4208 | Our Mission Medical Clinic 1811 W Katella Ave Ste 117 Anaheim CA 92804-6657 Ph: (657) 220-4208 |
| NPI Number | 1952886822 |
|---|---|
| Provider Enumeration Date | 09/26/2018 |
| Last Update Date | 08/07/2023 |
| Certification Date | 08/07/2023 |
| Medicare PECOS PAC ID | 5991044471 |
|---|---|
| Medicare Enrollment ID | O20190227001961 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952886822 | NPI | - | NPPES |
| Provider Name | Virginia A Aguilar |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1104994102 PECOS PAC ID: 8325066996 Enrollment ID: I20051102001178 |
| Provider Name | Hermilito Villar |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710946009 PECOS PAC ID: 4486729720 Enrollment ID: I20120305000235 |
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