Provider Demographics
NPI:1740381078
Name:GARDEN GROVE OUTPATIENT SURGERY CENTER
Entity Type:Organization
Organization Name:GARDEN GROVE OUTPATIENT SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:H
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:714-590-1452
Mailing Address - Street 1:13132 MAGNOLIA ST STE B
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-1326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13132 MAGNOLIA ST STE B
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1326
Practice Address - Country:US
Practice Address - Phone:714-590-1452
Practice Address - Fax:714-590-1352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051588Medicare ID - Type Unspecified