Northwest Surgical Development of Irvine

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

10305 Issued in CA

Legal business name

NORTHWEST SURGICAL DEVELOPMENT OF IRVINE

Doing business as

Athenix

Practice address

113 Waterworks Way Ste 300
Irvine, CA 92618-3174

Phone

(949) 450-0596

Fax

(949) 450-0804

NPI assigned

Jun 17, 2014

Organization subpart

No

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

Authorized official

Name

Mr. James Haefner

Title

Ceo

Phone

(949) 600-9931

Specialties & licenses 1

Addresses

Other names 1

• Athenix Doing business as

Locations

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1629482609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 ENTERPRISE STE 125",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926562706",
            "telephone_number": "949-600-9931",
            "fax_number": "949-600-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY STE 300",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183174",
            "telephone_number": "949-450-0596",
            "fax_number": "949-450-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SURGICAL DEVELOPMENT OF IRVINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-17",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "HAEFNER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-600-9931",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "10305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athenix",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Irvine, CA
• Providers in Irvine, 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 Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.