Healthcare Provider Details

I. General information

NPI: 1316041304
Provider Name (Legal Business Name): VALENCIA SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 LAGUNA ROAD
FULLERTON CA
92835
US

IV. Provider business mailing address

150 LAGUNA ROAD
FULLERTON CA
92835
US

V. Phone/Fax

Practice location:
  • Phone: 714-447-4800
  • Fax: 714-447-1098
Mailing address:
  • Phone: 714-447-4800
  • Fax: 714-447-1098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GORDON COLIN GUNN
Title or Position: SURGEON OWNER
Credential: MD
Phone: 714-992-2221