Provider Demographics
NPI:1053471516
Name:PLACENTIA LINDA ASSOCIATES
Entity Type:Organization
Organization Name:PLACENTIA LINDA ASSOCIATES
Other - Org Name:NORTH ORANGE COUNTY SURGICAL ASSOCIATES RNFA SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-255-1076
Mailing Address - Street 1:2922 ALDERGROVE CT
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-4327
Mailing Address - Country:US
Mailing Address - Phone:714-255-1076
Mailing Address - Fax:
Practice Address - Street 1:1301 N ROSE DR
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3802
Practice Address - Country:US
Practice Address - Phone:714-993-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467998163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty