MEDICARE: ASSOCIATED UROLOGISTS OF ORANGE COUNTY

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	208800000X	Urology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1235336397	OTHER		MEDICARE NPI

General Provider Information

NPI Number	:	1871881128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATED UROLOGISTS OF ORANGE COUNTY

Provider Business Mailing Address
First Line	:	1801 N BROADWAY
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92706-2607
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 N BROADWAY
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92706-2607
Country	:	US
Telephone Number	:	714-639-1915
Fax Number	:	714-824-6896

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	DR. GARO M. TERTZAKIAN
Credential	:
Telephone Number	:	714-639-1915

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	07/20/2011

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Directions to “ASSOCIATED UROLOGISTS OF ORANGE COUNTY ” Practice Location

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