Provider Demographics
NPI:1316041304
Name:VALENCIA SURGERY CENTER LLC
Entity Type:Organization
Organization Name:VALENCIA SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:COLIN
Authorized Official - Last Name:GUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-992-2221
Mailing Address - Street 1:150 LAGUNA ROAD
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835
Mailing Address - Country:US
Mailing Address - Phone:714-447-4800
Mailing Address - Fax:714-447-1098
Practice Address - Street 1:150 LAGUNA ROAD
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835
Practice Address - Country:US
Practice Address - Phone:714-447-4800
Practice Address - Fax:714-447-1098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051474AMedicare ID - Type Unspecified