=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932277886
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUNTINGTON SURGERY CENTER, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/30/2006
-----------------------------------------------------
Last Update Date | 04/04/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7801 CENTER AVE SUITE 102
-----------------------------------------------------
City | HUNTINGTON BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92647-9110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-230-2400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7801 CENTER AVE SUITE 102
-----------------------------------------------------
City | HUNTINGTON BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92647-9110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-230-2400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DR. PETER NEWEN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 714-230-2400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number | 060000939
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------