Healthcare Provider Details

I. General information

NPI: 1306080452
Provider Name (Legal Business Name): SURGERY CENTER OF IRVINE LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2009
Last Update Date: 04/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 POST SUITE B
IRVINE CA
92618-5223
US

IV. Provider business mailing address

3720 LOMITA BLVD FL 2
TORRANCE CA
90505-3884
US

V. Phone/Fax

Practice location:
  • Phone: 310-376-7000
  • Fax: 310-802-6268
Mailing address:
  • Phone: 310-376-7000
  • Fax: 310-802-6268

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: RIFAAT D SALEM
Title or Position: GENERAL PARTNER
Credential: M.D.
Phone: 310-376-7000