# CHILDREN'S SURGICAL ASSOCIATES, A MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1699777664
- **Authorized official:** JOHN GERMAN M.D. (PRESIDENT)
- **Authorized official phone:** (714) 289-4704

## Contact information

- **Practice address:** 1120 W LA VETA AVE, STE. 100, ORANGE, CA 92868-4231
- **Practice address phone:** (714) 571-5000
- **Practice address fax:** (714) 571-5055
- **Mailing address:** 1120 W LA VETA AVE, STE. 100, ORANGE, CA 92868-4231
- **Mailing address phone:** (714) 571-5000
- **Mailing address fax:** (714) 571-5055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | — | NULL | Yes |
| 2086S0120X | Pediatric Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/10/2005
- **Last updated:** 07/26/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0064800 | — | CA |
| 01 | — | ZZZ46292Z | BLUE SHIELD OF CA | CA |