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General NPI Number Information
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NPI Number | 1770720625
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Entity Type | Organization
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Legal Business Name | PACIFIC THORACIC SURGERY
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 24411 HEALTH CENTER DR SUITE 630
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3651
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Country | US
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Telephone | 949-716-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 24411 HEALTH CENTER DR SUITE 630
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3651
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Country | US
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Telephone | 949-716-2400
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Fax |
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Authorized Official
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Title or Position | SURGEON
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Name | DR. LEDFORD LEE POWELL
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Credential | MD, FACS, FCCP
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Telephone | 949-716-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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