Healthcare Provider Details

I. General information

NPI: 1861907107
Provider Name (Legal Business Name): UNITED SURGERY CENTER-ORANGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2017
Last Update Date: 12/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 W LA VETA AVE STE 550
ORANGE CA
92868-4214
US

IV. Provider business mailing address

25150 HANCOCK AVE STE 208
MURRIETA CA
92562-5989
US

V. Phone/Fax

Practice location:
  • Phone: 714-835-3636
  • Fax: 714-835-0315
Mailing address:
  • Phone: 951-764-9396
  • 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: KENNETH JONES
Title or Position: DIRECTOR OF BUSINESS OPERATIONS
Credential:
Phone: 951-764-9396