Provider Demographics
NPI:1568918548
Name:ORANGE PARTNERS SURGICENTER, LLC
Entity Type:Organization
Organization Name:ORANGE PARTNERS SURGICENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GHODADRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-596-1344
Mailing Address - Street 1:438 E KATELLA AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-4857
Mailing Address - Country:US
Mailing Address - Phone:310-508-4073
Mailing Address - Fax:
Practice Address - Street 1:438 E KATELLA AVE STE D
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-4857
Practice Address - Country:US
Practice Address - Phone:310-508-4073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116163261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical