# FOUNTIAN VALLEY REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255731428
- **Authorized official:** YOUNGHI KIM RN (RNFA)
- **Authorized official phone:** (714) 966-8128

## Contact information

- **Practice address:** 17100 EUCLID ST, FOUNTAIN VALLEY, CA 92708-4004
- **Practice address phone:** (714) 966-8128
- **Mailing address:** 21136 SUNWOOD DR, WALNUT, CA 91789-3317
- **Mailing address phone:** (909) 598-9908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 364193 | CA | Yes |

## Other

- **Enumeration date:** 08/25/2014
- **Last updated:** 08/25/2014