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General NPI Number Information
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NPI Number | 1104507110
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Entity Type | Organization
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Legal Business Name | FIVE POINTS SURGICAL CENTER, INC.
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 18800 DELAWARE ST # 525
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-1959
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Country | US
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Telephone | 855-263-9968
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Fax |
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Provider Business Mailing Address
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Address Line | 18685 MAIN ST # 101-338
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-1723
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Country | US
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Telephone | 855-263-9968
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. CHAD BOHORQUEZ
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Credential |
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Telephone | 714-791-3145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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