Provider Demographics
NPI:1043800691
Name:SURGICAL NURSING SERVICES INC.
Entity Type:Organization
Organization Name:SURGICAL NURSING SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:WALDBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, CNOR, RNFA
Authorized Official - Phone:714-951-1469
Mailing Address - Street 1:PO BOX 1622
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-1622
Mailing Address - Country:US
Mailing Address - Phone:714-951-1469
Mailing Address - Fax:
Practice Address - Street 1:5902 NUGGET CIR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-2131
Practice Address - Country:US
Practice Address - Phone:714-951-1469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty