Healthcare Provider Details

I. General information

NPI: 1922182245
Provider Name (Legal Business Name): BARRANCA MULTISPECIALTY SURGERY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 BARRANCA PKWY STE. 130
IRVINE CA
92606-8226
US

IV. Provider business mailing address

11999 SAN VICENTE BLVD STE. 440
LOS ANGELES CA
90049-5131
US

V. Phone/Fax

Practice location:
  • Phone: 949-552-6266
  • Fax:
Mailing address:
  • Phone: 310-440-3131
  • Fax:

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. ROBERT BELTRAN
Title or Position: OWNER
Credential: M.D.
Phone: 310-440-3131