Provider Demographics
NPI:1720547151
Name:SURGERYTRACK INC
Entity Type:Organization
Organization Name:SURGERYTRACK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSCOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-294-9874
Mailing Address - Street 1:23961 CALLE MAGDALENA
Mailing Address - Street 2:SUITE 405
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-697-7162
Mailing Address - Fax:
Practice Address - Street 1:23961 CALLE MAGDALENA
Practice Address - Street 2:SUITE 405
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-697-7162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty