Organization
REAGAN STREET SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BOON (OFFICER/AUTHORIZED OFFICIAL)
(480) 567-0269
Entity
Organization
Contact information
Practice address
10904 REAGAN ST, LOS ALAMITOS, CA 90720-2435
(562) 596-3140
(562) 596-3142
Mailing address
14201 DALLAS PKWY, DALLAS, TX 75254-2916
(972) 763-3859
(562) 596-3142
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/07/2006
Last updated
10/11/2024
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