Provider Demographics
NPI:1699077842
Name:ALLIED SURGERY CENTER
Entity type:Organization
Organization Name:ALLIED SURGERY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PASILLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:714-919-5883
Mailing Address - Street 1:13132 NEWPORT AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3429
Mailing Address - Country:US
Mailing Address - Phone:714-919-5883
Mailing Address - Fax:714-464-4456
Practice Address - Street 1:13132 NEWPORT AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780
Practice Address - Country:US
Practice Address - Phone:714-919-5883
Practice Address - Fax:714-464-4456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-20
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA542526OtherJOINT COMMISSION
CA92272OtherAAAHC / ACCREDITATION