Advanced Surgical Care Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

A642450 Issued in CA

Legal business name

ADVANCED SURGICAL CARE MEDICAL CORPORATION

Practice address

12555 Garden Grove Blvd
303
Garden Grove, CA 92843-1902

Phone

(714) 537-7766

NPI assigned

May 14, 2007

Organization subpart

No

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

Authorized official

Name

Francis Sangwon Lee, MD

Title

Owner

Phone

(714) 537-7766

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1801002464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12555 GARDEN GROVE BLVD",
            "address_2": "303",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431902",
            "telephone_number": "714-537-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12555 GARDEN GROVE BLVD",
            "address_2": "303",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431902",
            "telephone_number": "714-537-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SURGICAL CARE MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_middle_name": "SANGWON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-537-7766",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A642450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A642450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Garden Grove, CA
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.