Provider Demographics
NPI:1235542044
Name:ACS MED CORP
Entity Type:Organization
Organization Name:ACS MED CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-912-8525
Mailing Address - Street 1:1400 REYNOLDS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5559
Mailing Address - Country:US
Mailing Address - Phone:714-912-8525
Mailing Address - Fax:
Practice Address - Street 1:1400 REYNOLDS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-5559
Practice Address - Country:US
Practice Address - Phone:714-912-8525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABUS1300797261QP2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health