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General NPI Number Information
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NPI Number | 1376244400
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Entity Type | Organization
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Legal Business Name | DISTINCTION SURGERY CENTER
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Dates
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Enumeration Date | 03/15/2023
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Last Update Date | 03/15/2023
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Provider Practice Location Address
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Address Line | 4501 BIRCH ST
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1990
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Country | US
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Telephone | 949-888-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 4501 BIRCH ST
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1990
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Country | US
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Telephone | 949-888-9700
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Fax |
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Authorized Official
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Title or Position | MD/DIRECTOR
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Name | JOHN COMPOGINIS
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Credential | MD
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Telephone | 949-888-9700
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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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