PEGASUS SURGERY CENTER LLC NPI 1366044596

NPI Information

NPI: 1366044596
Provider Name: PEGASUS SURGERY CENTER LLC
Classification: Clinic/Center - 261QA1903X
Specialization: Ambulatory Surgical
Entity Type: Organization
Former Legal Business Name: PEGASUS SURGERY CENTER, LLC
CLIA Number: 05D2246484
Address: 20162 SW BIRCH ST STE 100
NEWPORT BEACH, CA
ZIP 92660
Phone: (949) 508-1198

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NPI Details

PEGASUS SURGERY CENTER LLC is an ambulatory surgical clinic center in Newport Beach, CA. PEGASUS SURGERY CENTER LLC NPI is 1366044596. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Pegasus Surgery Center, Llc.

The provider's business location address is:

20162 SW BIRCH ST STE 100
NEWPORT BEACH, CA
ZIP 92660-797
Phone: (949) 508-1198
Fax: (949) 449-8564

The provider's authorized official is Michael Tassos .
The authorized official title is Cfo and has the following contact phone number (661) 965-5020.

The CLIA number assigned to this NPI record is 05D2246484 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/12/2020 and was last updated on 12/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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