# BOLSA OUTPATIENT SURGERY CENTER A MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1962500454
- **Authorized official:** DR. CO D.L. PHAM M.D. (PRESIDENT)
- **Authorized official phone:** (714) 775-5690

## Contact information

- **Practice address:** 10362 BOLSA AVE STE 100, WESTMINSTER, CA 92683-6763
- **Practice address phone:** (714) 775-5690
- **Practice address fax:** (714) 775-7405
- **Mailing address:** 10362 BOLSA AVE STE 100, WESTMINSTER, CA 92683-6763
- **Mailing address phone:** (714) 775-5690
- **Mailing address fax:** (714) 775-7405

## Taxonomy

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

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 07/13/2017