Healthcare Provider Details

I. General information

NPI: 1184981326
Provider Name (Legal Business Name): REPRODUCTIVE SPECIALTY SURGICAL CENTER , INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 12/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15500 SAND CANYON AVE SUITE 100
IRVINE CA
92618-7709
US

IV. Provider business mailing address

15500 SAND CANYON AVE SUITE 100
IRVINE CA
92618-7709
US

V. Phone/Fax

Practice location:
  • Phone: 949-726-0600
  • Fax: 949-726-0601
Mailing address:
  • Phone: 949-726-0600
  • Fax: 949-726-0601

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: MS. MARIA BAUER
Title or Position: CFO/ADMINISTRATOR
Credential:
Phone: 949-726-0600