MEDICARE: BEACH SURGERY CENTER INC.

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
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1831872746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACH SURGERY CENTER INC.

Provider Business Mailing Address
First Line	:	20951 BROOKHURST ST
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-6648
Country	:	US
Telephone Number	:	909-991-5342
Fax Number	:

Provider Business Practice Location Address
First Line	:	20951 BROOKHURST ST
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-6648
Country	:	US
Telephone Number	:	909-991-5342
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TUAN TRAN
Credential	:
Telephone Number	:	909-991-5342

Provider Enumeration Date	:	08/08/2023
Last Update Date	:	09/05/2023

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