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NPI Code Detail

MEDICARE: ORANGE ASC, LLC

MEDICARE: ORANGE ASC, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1780059014
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORANGE ASC, LLC
Provider Business Mailing Address
First Line : 100 E CALIFORNIA BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91105-3205
Country : US
Telephone Number : 626-269-5311
Fax Number : 626-574-7188
Provider Business Practice Location Address
First Line : 1403 N TUSTIN AVE STE 100
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-8691
Country : US
Telephone Number : 626-269-5311
Fax Number : 626-574-7188
Authorized Official
Title or Position : CEO
Name : DR. TOM S CHANG
Credential : M.D.
Telephone Number : 626-676-0838
Provider Enumeration Date : 12/11/2015
Last Update Date : 10/12/2022

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Directions to “ORANGE ASC, LLC ” Practice Location

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