Provider Demographics
NPI:1134349533
Name:ORANGE COUNTY EMERGENCY SURGICAL SPECIALISTS, INC
Entity type:Organization
Organization Name:ORANGE COUNTY EMERGENCY SURGICAL SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:NASTANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-289-1559
Mailing Address - Street 1:PO BOX 2247
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92859-0247
Mailing Address - Country:US
Mailing Address - Phone:714-289-1559
Mailing Address - Fax:714-289-0280
Practice Address - Street 1:999 N TUSTIN AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3528
Practice Address - Country:US
Practice Address - Phone:714-547-1915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68851146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ50604YOtherBLUE SHIELD
CAZZZ50604YOtherBLUE SHIELD