Imperial Surgical Centre LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

IMPERIAL SURGICAL CENTRE LLC

Practice address

295 Imperial Hwy
Fullerton, CA 92835-1020

Phone

(714) 770-8300

NPI assigned

Feb 17, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Alvaro Liceaga, M.D.

Title

Medical Director

Phone

(714) 770-8300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1730452087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 IMPERIAL HWY",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351020",
            "telephone_number": "714-770-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 IMPERIAL HWY",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351020",
            "telephone_number": "714-770-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL SURGICAL CENTRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "LICEAGA",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "714-770-8300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Illumination Health and Home
• Dongwhan Dustin Im, PHYSICIAN ASSISTANT
• Jenny Im, ND
• Andrew Imparato, M.D
• Imperial Anesthesia Medical Group
• Sonaina Imtiaz, MD
• Denise Mayra Inda
• Index Investments Inc Dba Fullerton Res Manor
• Celeste Monique Oliver Infante
• Tristyn Mikel Ingallinera, MFTI

• 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 Feb 17, 2012; 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.