Pegasus Surgery Center LLC
Clinic/Center, Ambulatory Surgical in Newport Beach, CA. Organization (NPI-2).
NPI number1366044596
StatusActive
Last updated in NPPESDec 8, 2021
Details
- NPI
- 1366044596
- Entity type
- Organization (NPI-2)
- Legal business name
- Pegasus Surgery Center LLC
- Organization subpart
- No
- Enumeration date
- Nov 12, 2020
- Certification date
- Dec 8, 2021
- Last updated
- Dec 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QA1903X | Clinic/Center, Ambulatory Surgical | – | – | Yes |
Other names
- Pegasus Surgery Center, LLC (Former Legal Business Name)
Practice location
20162 Sw Birch St Ste 100Newport Beach, CA 92660-0797
Phone 949-508-1198 · Fax 949-449-8564
Mailing address
13071 SolindaTustin, CA 92782-8709
Phone 661-965-5020
Authorized official
Michael Tassos
Cfo
6619655020
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