Healthcare Provider Details
I. General information
NPI: 1033734728
Provider Name (Legal Business Name): ORANGE COUNTY SURGICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2020
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1400 REYNOLDS AVE STE 109
IRVINE CA
92614-5559
US
IV. Provider business mailing address
1400 REYNOLDS AVE STE 109
IRVINE CA
92614-5559
US
V. Phone/Fax
- Phone: 949-390-9000
- Fax:
- Phone: 949-390-9000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
J.
HEWETT
Title or Position: PRESIDENT
Credential: MD
Phone: 949-390-9000