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 2 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