Provider Demographics
NPI:1477239267
Name:ACUTE CARE SURGERY MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:ACUTE CARE SURGERY MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:FLACKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-441-0400
Mailing Address - Street 1:PO BOX 888102
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90088-8102
Mailing Address - Country:US
Mailing Address - Phone:916-441-0400
Mailing Address - Fax:916-441-0406
Practice Address - Street 1:14300 ORCHARD PARKWAY SUITE #200
Practice Address - Street 2:
Practice Address - City:WESTMINSTER,
Practice Address - State:CO
Practice Address - Zip Code:80023
Practice Address - Country:US
Practice Address - Phone:720-523-1174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Single Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Single Specialty