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General NPI Number Information
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NPI Number | 1699077842
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Entity Type | Organization
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Legal Business Name | ALLIED SURGERY CENTER
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Dates
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Enumeration Date | 11/20/2010
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 13132 NEWPORT AVE SUITE 210
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City | TUSTIN
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State | CA
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Zip | 92780
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Country | US
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Telephone | 714-919-5883
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Fax | 714-464-4456
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Provider Business Mailing Address
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Address Line | 13132 NEWPORT AVE SUITE 210
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City | TUSTIN
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State | CA
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Zip | 92780-3429
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Country | US
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Telephone | 714-919-5883
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Fax | 714-464-4456
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. LETICIA PASILLAS
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Credential | M.B.A
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Telephone | 714-919-5883
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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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