REAGAN STREET SURGERY CENTER LLC NPI 1447213954

NPI Information

REAGAN STREET SURGERY CENTER, LLC is an ambulatory surgical clinic center in Los Alamitos, CA. REAGAN STREET SURGERY CENTER, LLC NPI is 1447213954. The provider is registered as an organization entity type.

The provider's business location address is:

10904 REAGAN ST
LOS ALAMITOS, CA
ZIP 90720-435
Phone: (562) 596-3140
Fax: (562) 596-3142

The provider's authorized official is Eric Boon .
The authorized official title is Officer/authorized Official and has the following contact phone number (480) 567-0269.

The CLIA number assigned to this NPI record is 05D1046415 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/7/2006 and was last updated on 8/14/2020.

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:

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