# IRVINE SURGICAL MEDICAL GROUP CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** IRVINE ENDOSCOPY AND SURGICAL INSTITUTE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578652152
- **Authorized official:** ARDALAN BABAKNIA PHD,M.D. (CHIEF MEDICAL DIRECTOR AND FINANCIA)
- **Authorized official phone:** (949) 753-8844

## Contact information

- **Practice address:** 15825 LAGUNA CANYON RD, SUITE 100, IRVINE, CA 92618-2125
- **Practice address phone:** (949) 679-6700
- **Practice address fax:** (949) 387-9530
- **Mailing address:** 15825 LAGUNA CANYON RD, SUITE 100, IRVINE, CA 92618-2125
- **Mailing address phone:** (949) 679-6700
- **Mailing address fax:** (949) 387-9530

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 550000008 | CA | Yes |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 05/15/2008