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Organization

SOUTH ORANGE COUNTY SURGICAL MEDICAL GROUP, INC.

Active
Other names
OC Surgeons Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WILLIAM CAMPBELL WALLACE MD (CEO)
(949) 457-7900
Entity
Organization

Contact information

Practice address
24411 HEALTH CENTER DR, SUITE 350, LAGUNA HILLS, CA 92653-3651
(949) 457-7900
(949) 583-9148
Mailing address
24411 HEALTH CENTER DR STE 350, LAGUNA HILLS, CA 92653-3687
(949) 457-7900
(949) 583-9148

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2086S0129X
Vascular Surgery Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W1079
MEDICARE PTAN
CA
Enumeration date
07/29/2006
Last updated
10/06/2025
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