Healthcare Provider Details

I. General information

NPI: 1811070774
Provider Name (Legal Business Name): ORANGE COAST PLASTIC SURGERY MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 W STEWART DR STE. 610
ORANGE CA
92868-3854
US

IV. Provider business mailing address

681 S PARKER ST STE. 100
ORANGE CA
92868-4719
US

V. Phone/Fax

Practice location:
  • Phone: 714-997-4300
  • Fax: 714-997-5759
Mailing address:
  • Phone: 714-571-5000
  • Fax: 714-571-5055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: IVAN TURPIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-997-4300