# BASIC IRVINE ASC, INC.

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

## Provider details

- **NPI number:** 1770925893
- **Authorized official:** GOWRIHARAN THAIYANANTHAN (OWNER)
- **Authorized official phone:** (949) 556-4800

## Contact information

- **Practice address:** 18 ENDEAVOR, 103, IRVINE, CA 92618-3164
- **Practice address phone:** (949) 556-4800
- **Practice address fax:** (949) 502-8591
- **Mailing address:** 18 ENDEAVOR, 103, IRVINE, CA 92618-3164
- **Mailing address phone:** (949) 556-4800
- **Mailing address fax:** (949) 502-8591

## Taxonomy

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

## Other

- **Enumeration date:** 07/18/2013
- **Last updated:** 02/09/2016