Provider Demographics
NPI:1922238096
Name:OC MULTI SPECIALTY SURGERY CENTER
Entity Type:Organization
Organization Name:OC MULTI SPECIALTY SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:714-282-2222
Mailing Address - Street 1:145 S CHAPARRAL CT STE 101
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-2265
Mailing Address - Country:US
Mailing Address - Phone:714-282-2222
Mailing Address - Fax:714-282-2244
Practice Address - Street 1:145 S CHAPARRAL CT STE 101
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-2265
Practice Address - Country:US
Practice Address - Phone:714-282-2222
Practice Address - Fax:714-282-2244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical