Provider Demographics
NPI:1811070774
Name:ORANGE COAST PLASTIC SURGERY MEDICAL CORPORATION
Entity type:Organization
Organization Name:ORANGE COAST PLASTIC SURGERY MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TURPIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-997-4300
Mailing Address - Street 1:681 S PARKER ST
Mailing Address - Street 2:STE. 100
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4719
Mailing Address - Country:US
Mailing Address - Phone:714-571-5000
Mailing Address - Fax:714-571-5055
Practice Address - Street 1:1310 W STEWART DR
Practice Address - Street 2:STE. 610
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3854
Practice Address - Country:US
Practice Address - Phone:714-997-4300
Practice Address - Fax:714-997-5759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty