Provider Demographics
NPI:1407994270
Name:FOOTHILL RANCH SURGI-CENTER
Entity Type:Organization
Organization Name:FOOTHILL RANCH SURGI-CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIBHA
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-837-3000
Mailing Address - Street 1:26781 PORTOLA PKWY
Mailing Address - Street 2:SUITE 4E
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-1758
Mailing Address - Country:US
Mailing Address - Phone:949-837-3000
Mailing Address - Fax:949-837-7585
Practice Address - Street 1:26781 PORTOLA PKWY
Practice Address - Street 2:SUITE 4E
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-1758
Practice Address - Country:US
Practice Address - Phone:949-837-3000
Practice Address - Fax:949-837-7585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical