Healthcare Provider Details

I. General information

NPI: 1134349533
Provider Name (Legal Business Name): ORANGE COUNTY EMERGENCY SURGICAL SPECIALISTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 03/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 N TUSTIN AVE SUITE 116
SANTA ANA CA
92705-3528
US

IV. Provider business mailing address

PO BOX 2247
ORANGE CA
92859-0247
US

V. Phone/Fax

Practice location:
  • Phone: 714-547-1915
  • Fax:
Mailing address:
  • Phone: 714-289-1559
  • Fax: 714-289-0280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License NumberA68851
License Number StateCA

VIII. Authorized Official

Name: FRANK NASTANSKI
Title or Position: PRESIDENT
Credential: MD
Phone: 714-289-1559