Mesa Surgicenter

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MESA SURGICENTER

Practice address

100 E Valencia Mesa Dr # 303
Fullerton, CA 92835-3813

Phone

(714) 738-4282

NPI assigned

Jan 18, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert Martin Wald Jr., MDNPI 1952477507

Title

Physician

Phone

(714) 738-4282

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 05C0001352

Legal name

MESA SURGICENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jul 25, 1996

Last certification

Apr 5, 2014

Ownership / control type

Government

Facility address

100 E Valencia Mesa Dr, Suite 303
Fullerton, CA 92835

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert M Wald Jr., MD INC

  • Plastic Surgery Physician
  • Fullerton, CA
  • NPI 1952477507
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053463984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR # 303",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR # 303",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353813",
            "telephone_number": "714-738-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA SURGICENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "714-738-4282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Monique Mercado
• Jessica Adela Mercado
• Sarah Mercado, OTR/L
• Michael Meris
• Heather Merizan
• Cassandra Lynn Mesa
• Lucie L. Methot, D.C.
• Paul Methot, D.C.
• Eric Martin Meyer, DDS
• Hailey Shea Meyer

• Ambulatory Surgical Clinic/Center in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.