Provider Demographics
NPI:1093087694
Name:EMPIRE SURGICAL CENTER, INC
Entity Type:Organization
Organization Name:EMPIRE SURGICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-568-8838
Mailing Address - Street 1:1310 W STEWART DRIVE
Mailing Address - Street 2:STE. 310
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3838
Mailing Address - Country:US
Mailing Address - Phone:714-633-1338
Mailing Address - Fax:714-633-1388
Practice Address - Street 1:1310 W STEWART DRIVE
Practice Address - Street 2:STE. 310
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3838
Practice Address - Country:US
Practice Address - Phone:714-633-1338
Practice Address - Fax:714-633-1388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000365261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical