Provider Demographics
NPI:1124187562
Name:IRVINE MULTI SPECIALTY SURGICAL CARE
Entity Type:Organization
Organization Name:IRVINE MULTI SPECIALTY SURGICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARROTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-726-0682
Mailing Address - Street 1:4900 BARRANCA PKWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-8603
Mailing Address - Country:US
Mailing Address - Phone:949-726-0677
Mailing Address - Fax:949-653-1852
Practice Address - Street 1:4900 BARRANCA PKWY
Practice Address - Street 2:SUITE 104
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-8603
Practice Address - Country:US
Practice Address - Phone:949-726-0677
Practice Address - Fax:949-653-1852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051335Medicare ID - Type Unspecified