Provider Demographics
NPI:1770023814
Name:CORONA SURGERY CENTER, INC
Entity Type:Organization
Organization Name:CORONA SURGERY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-272-5722
Mailing Address - Street 1:400 E RINCON ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1389
Mailing Address - Country:US
Mailing Address - Phone:951-272-2221
Mailing Address - Fax:951-272-2226
Practice Address - Street 1:400 E RINCON ST
Practice Address - Street 2:SUITE 107
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1389
Practice Address - Country:US
Practice Address - Phone:951-272-2221
Practice Address - Fax:951-272-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical