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Organization
ST JUDE CARDIOTHORACIC SURGEONS
Active
Organization
ST JUDE CARDIOTHORACIC SURGEONS
Active
Parent organization
ORANGE COUNTY THORACIC & CARDIOVASCULAR SURGEONS
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORANGE COUNTY THORACIC & CARDIOVASCULAR SURGEONS
Authorized official
RICHARD N GATES MD (CHIEF EXECUTIVE OFFICER)
(714) 997-2224
Entity
Organization
Contact information
Practice address
301 W BASTANCHURY RD, SUITE 195, FULLERTON, CA 92835-3419
(714) 446-8866
(714) 997-1187
Mailing address
1310 W STEWART DR, SUITE 503, ORANGE, CA 92868-3854
(714) 997-2224
(714) 997-1187
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FNP 36248
STATE OF CA MEDICAL BOARD
CA
Enumeration date
10/19/2007
Last updated
08/06/2020
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