Provider Demographics
NPI:1265689046
Name:MOBISURG, INC.
Entity Type:Organization
Organization Name:MOBISURG, INC.
Other - Org Name:PEDIATRIC AND SPECIALTY SURGERY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAHRIAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIKHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-367-0800
Mailing Address - Street 1:23025 MILL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1257
Mailing Address - Country:US
Mailing Address - Phone:949-367-0800
Mailing Address - Fax:949-313-7858
Practice Address - Street 1:23025 MILL CREEK DR
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1257
Practice Address - Country:US
Practice Address - Phone:949-367-0800
Practice Address - Fax:949-313-7858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75045261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical