Basic Information
| Provider Information | |||||||||
| NPI: | 1306993464 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PACIFIC HILLS SURGERY CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24022 CALLE DE LA PLATA | ||||||||
| Address2: | #180 | ||||||||
| City: | LAGUNA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926533627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9494583551 | ||||||||
| FaxNumber: | 9499519478 | ||||||||
| Practice Location | |||||||||
| Address1: | 24022 CALLE DE LA PLATA | ||||||||
| Address2: | #180 | ||||||||
| City: | LAGUNA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926533627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9494583551 | ||||||||
| FaxNumber: | 9499519478 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 01/29/2009 | ||||||||
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| AuthorizedOfficialLastName: | JOYCE | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | V | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9498547400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.