Provider Demographics
NPI:1336672989
Name:ALISO VIEJO SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:ALISO VIEJO SURGERY CENTER, LLC
Other - Org Name:ALISO VIEJO SURGERY CENTER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-860-1081
Mailing Address - Street 1:2 JOURNEY
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3332
Mailing Address - Country:US
Mailing Address - Phone:949-860-1081
Mailing Address - Fax:
Practice Address - Street 1:2 JOURNEY
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3332
Practice Address - Country:US
Practice Address - Phone:949-860-1081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical