Provider Demographics
NPI:1548430572
Name:EUCLID OUTPATIENT SURGERY CENTER
Entity Type:Organization
Organization Name:EUCLID OUTPATIENT SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAAD
Authorized Official - Middle Name:
Authorized Official - Last Name:JEIROUDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-918-5181
Mailing Address - Street 1:17150 EUCLID ST
Mailing Address - Street 2:SUITE 216
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4092
Mailing Address - Country:US
Mailing Address - Phone:714-918-5181
Mailing Address - Fax:
Practice Address - Street 1:17150 EUCLID ST
Practice Address - Street 2:SUITE 216
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4092
Practice Address - Country:US
Practice Address - Phone:714-918-5181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical