MEDICARE: HEIGHTS SURGICAL INSTITUTE

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	:	1982234944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEIGHTS SURGICAL INSTITUTE

Provider Business Mailing Address
First Line	:	455 OLD NEWPORT BLVD STE 100
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4254
Country	:	US
Telephone Number	:	959-585-2282
Fax Number	:	949-484-6966

Provider Business Practice Location Address
First Line	:	455 OLD NEWPORT BLVD STE 100
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4254
Country	:	US
Telephone Number	:	959-585-2282
Fax Number	:	949-484-6966

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	KEVIN D TRINH
Credential	:	MD
Telephone Number	:	949-378-4423

Provider Enumeration Date	:	01/17/2020
Last Update Date	:	01/17/2020

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Directions to “HEIGHTS SURGICAL INSTITUTE ” Practice Location

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