| Mission Plaza Medical Group | |
|
11550 Indian Hills Rd Ste 380 Mission Hills CA 91345 | |
| (818) 361-5311 | |
| (818) 837-0042 |
| Full Name | Mission Plaza Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 11550 Indian Hills Rd, Mission Hills, California |
| Authorized Official Name and Position | Michael Palazzolo (PRESIDENT) |
| Authorized Official Contact | 8183615311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mission Plaza Medical Group 11550 Indian Hills Rd Ste 380 Mission Hills CA 91345 Ph: (818) 361-5311 | Mission Plaza Medical Group 11550 Indian Hills Rd Ste 380 Mission Hills CA 91345 Ph: (818) 361-5311 |
| NPI Number | 1538283379 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538283379 | NPI | - | NPPES |
| 1942274212 | Other | NPI | |
| 00A339980 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A33998 (California) | Primary |
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