Provider Demographics
NPI:1306080452
Name:SURGERY CENTER OF IRVINE LP
Entity type:Organization
Organization Name:SURGERY CENTER OF IRVINE LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RIFAAT
Authorized Official - Middle Name:D
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-376-7000
Mailing Address - Street 1:3720 LOMITA BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3884
Mailing Address - Country:US
Mailing Address - Phone:310-376-7000
Mailing Address - Fax:310-802-6268
Practice Address - Street 1:10 POST
Practice Address - Street 2:SUITE B
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-5223
Practice Address - Country:US
Practice Address - Phone:310-376-7000
Practice Address - Fax:310-802-6268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical