Healthcare Provider Details
I. General information
NPI: 1790613107
Provider Name (Legal Business Name): ELITE SURGERY CENTER OF ORANGE COUNTY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
999 N TUSTIN AVE STE 105
SANTA ANA CA
92705-6501
US
IV. Provider business mailing address
999 N TUSTIN AVE STE 105
SANTA ANA CA
92705-6501
US
V. Phone/Fax
- Phone: 949-566-8688
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAMES
A.
KIM
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 949-566-8688