Organization
MAINBRIDGE SURGERY CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY WONG MD (MEDICAL DIRECTOR)
(714) 771-9252
Entity
Organization
Contact information
Practice address
400 E RINCON ST, SUITE 107, CORONA, CA 92879-1389
(714) 771-9252
(714) 771-8481
Mailing address
400 E RINCON ST, SUITE 107, CORONA, CA 92879-1389
(714) 771-9252
(714) 771-8481
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
G45605
CA
Other
Enumeration date
10/23/2013
Last updated
10/23/2013
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