# FOOTHILL GATEWAY SURGERY CENTER LLC

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

## Provider details

- **NPI number:** 1588709489
- **Authorized official:** PATTI THOMPSON (BILLING MANAGER)
- **Authorized official phone:** (949) 305-6336

## Contact information

- **Practice address:** 29300 PORTOLA PKWY STE A, LAKE FOREST, CA 92630-8718
- **Practice address phone:** (949) 305-6336
- **Practice address fax:** (949) 767-5764
- **Mailing address:** 29300 PORTOLA PKWY STE A, LAKE FOREST, CA 92630-8718
- **Mailing address phone:** (949) 305-6336
- **Mailing address fax:** (949) 767-5764

## Taxonomy

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

## Other

- **Enumeration date:** 02/20/2007
- **Last updated:** 10/22/2010