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Organization
IRVINE SPECIALTY CARE SURGERY CENTER
Active
Organization
IRVINE SPECIALTY CARE SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHURAM SIAL M.D (PRESIDENT)
(949) 416-1070
Entity
Organization
Contact information
Practice address
4968 BOOTH CIR STE 105, IRVINE, CA 92604-3366
(951) 734-7246
(951) 674-7244
Mailing address
31569 CANYON ESTATES DR STE 135, LAKE ELSINORE, CA 92532-0472
(951) 734-7246
(951) 674-7244
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
NULL
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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