OrganizationMission Center For Longevity & Aesthetic MedicineInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address26730 Crown Valley Pkwy Ste 250, Mission Viejo, CA 92691-8000(949) 364-2440PECOS EnrollmentBased on the most recent information from CMS, provider Mission Center For Longevity & Aesthetic Medicine does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1740418680Provider TypeOrganizationFull NameMission Center For Longevity & Aesthetic MedicineSubpartNoEnumeration Date6/30/2009Last Updated6/30/2009Contact InformationPractice LocationPractice Address26730 Crown Valley Pkwy Ste 250, Mission Viejo, CA 92691-8000Phone(949) 364-2440Fax(949) 364-2778Mailing LocationMailing Address26730 Crown Valley Pkwy Ste 250, Mission Viejo, CA 92691-8000Phone(949) 364-2440Fax(949) 364-2778Authorized OfficialNameHeinrich, James Alan (President Of The Board)Phone(949) 364-2440Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseA64307CaliforniaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseG69073CaliforniaCode207YX0905XDescriptionOtolaryngologyAllopathic & Osteopathic PhysiciansLicenseG66486California