Organization
CCC SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY CHEN M.D. (PRESIDENT)
(714) 833-5558
Entity
Organization
Contact information
Practice address
1000 S ANAHEIM BLVD, SUITE 300, ANAHEIM, CA 92805
(714) 833-5558
Mailing address
1000 S ANAHEIM BLVD, SUITE 300, ANAHEIM, CA 92805
(714) 833-5558
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10214
IMQ (INSTITUTE FOR MEDICAL QUALITY)
CA
Enumeration date
10/15/2012
Last updated
11/12/2013
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