Organization
ST JOSEPH SURGERY & LASER CENTER INC
Active
Other names
SAINT MARY AND JOSEPH SURGERY AND LASER CENTER, INC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN RUPER (CEO)
(714) 633-6060
Entity
Organization
Contact information
Practice address
436 S GLASSELL ST, ORANGE, CA 92866-1906
(714) 633-9566
(714) 633-7470
Mailing address
436 S GLASSELL ST, ORANGE, CA 92866-1906
(714) 633-9566
(714) 633-7470
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
060000429
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SUR70020F
—
CA
01
—
ZZZH4044Z
BLUE SHIELD
CA
Enumeration date
05/24/2006
Last updated
10/13/2008
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