Organization
MAIN STREET SPECIALTY SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY TANNER (BUSINESS ADMINISTRATION)
(714) 704-1900
Entity
Organization
Contact information
Practice address
280 S MAIN ST, SUITE 100, ORANGE, CA 92868-3852
(714) 704-1900
(714) 704-1912
Mailing address
280 S MAIN ST, SUITE 100, ORANGE, CA 92868-3852
(714) 704-1900
(714) 704-1912
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
CA
Other
Enumeration date
09/30/2005
Last updated
08/22/2020
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