Provider Demographics
NPI:1013165380
Name:NORTH TUSTIN SURGERY CENTER, INC.
Entity type:Organization
Organization Name:NORTH TUSTIN SURGERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:ERNESTO
Authorized Official - Last Name:ANGUIZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-664-0905
Mailing Address - Street 1:1200 N TUSTIN AVE
Mailing Address - Street 2:SUITE 155
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3508
Mailing Address - Country:US
Mailing Address - Phone:714-543-3800
Mailing Address - Fax:714-543-6038
Practice Address - Street 1:1200 N TUSTIN AVE
Practice Address - Street 2:SUITE 155
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3508
Practice Address - Country:US
Practice Address - Phone:714-543-3800
Practice Address - Fax:714-543-6038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical