Provider Demographics
NPI:1144745803
Name:ORANGE COUNTY ROBOTIC GENERAL SURGERY INC
Entity Type:Organization
Organization Name:ORANGE COUNTY ROBOTIC GENERAL SURGERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABTIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:KHOSRAVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-541-4996
Mailing Address - Street 1:PO BOX 5871
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863-5871
Mailing Address - Country:US
Mailing Address - Phone:714-571-5000
Mailing Address - Fax:714-571-5055
Practice Address - Street 1:1010 W LA VETA AVE STE 775
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4306
Practice Address - Country:US
Practice Address - Phone:714-541-4996
Practice Address - Fax:714-835-9550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-03
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty