Provider Demographics
NPI:1215338868
Name:MEMORIALCARE SURGICAL CENTER AT SADDLEBACK LLC
Entity type:Organization
Organization Name:MEMORIALCARE SURGICAL CENTER AT SADDLEBACK LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-458-5600
Mailing Address - Street 1:27882 FORBES RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1267
Mailing Address - Country:US
Mailing Address - Phone:949-347-2400
Mailing Address - Fax:949-347-2424
Practice Address - Street 1:27882 FORBES RD
Practice Address - Street 2:SUITE 203
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1267
Practice Address - Country:US
Practice Address - Phone:949-347-2400
Practice Address - Fax:949-347-2424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical