Healthcare Provider Details

I. General information

NPI: 1619797263
Provider Name (Legal Business Name): OC SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15775 LAGUNA CANYON RD STE 110
IRVINE CA
92618-3192
US

IV. Provider business mailing address

15775 LAGUNA CANYON RD STE 110
IRVINE CA
92618-3192
US

V. Phone/Fax

Practice location:
  • Phone: 949-228-1022
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CYRUS SEDAGHAT
Title or Position: OWNER
Credential: MD
Phone: 949-228-1022