Provider Demographics
NPI:1205490448
Name:SURGICAL OASIS INSTITUTE
Entity type:Organization
Organization Name:SURGICAL OASIS INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:SAEED
Authorized Official - Last Name:IRANIHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-646-8444
Mailing Address - Street 1:496 OLD NEWPORT BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4264
Mailing Address - Country:US
Mailing Address - Phone:949-646-8444
Mailing Address - Fax:949-646-8388
Practice Address - Street 1:496 OLD NEWPORT BLVD STE 2
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4264
Practice Address - Country:US
Practice Address - Phone:949-646-8444
Practice Address - Fax:949-646-8388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA55391OtherSTATE MEDICAL LICENSE