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General NPI Number Information
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NPI Number | 1407806904
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Entity Type | Organization
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Legal Business Name | UNIVERSITY SURGEONS OF ORANGE A MEDICAL GROUP
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 101 THE CITY DR S
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City | ORANGE
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State | CA
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Zip | 92868
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Country | US
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Telephone | 714-456-7212
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Fax | 714-456-7601
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Provider Business Mailing Address
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Address Line | PO BOX 31001-2446
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City | PASADENA
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State | CA
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Zip | 91110-2446
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT MANAGER
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Name | SYLVIA COPEN
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Credential |
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Telephone | 714-456-6227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #7
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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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