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General NPI Number Information
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NPI Number | 1114707601
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Entity Type | Organization
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Legal Business Name | GENESIS AMBULATORY SURGERY CENTER INC
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 1401 N TUSTIN AVE STE 105
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City | SANTA ANA
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State | CA
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Zip | 92705-8679
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Country | US
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Telephone | 949-837-3000
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Fax | 949-259-6978
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Provider Business Mailing Address
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Address Line | PO BOX 2393
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City | ORANGE
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State | CA
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Zip | 92859-0393
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Country | US
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Telephone | 949-837-3000
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Fax | 949-259-6978
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Authorized Official
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Title or Position | CEO
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Name | YASSER HILMY SALEM
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Credential | MD
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Telephone | 714-545-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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