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Organization
CHAMPION SURGERY CENTER, LLC
Active
Organization
CHAMPION SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HUU PHAM M.D (MEDICAL DIRECTOR)
(562) 842-3595
Entity
Organization
Contact information
Practice address
4463 BIRCH ST, STE 150, NEWPORT BEACH, CA 92660-1911
(562) 842-3595
Mailing address
11244 SNOWDROP AVE, FOUNTAIN VALLEY, CA 92708
(714) 566-5240
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
11/06/2015
Last updated
07/31/2017
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