Bolsa Outpatient Surgery Center a Medical Corporation

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BOLSA OUTPATIENT SURGERY CENTER A MEDICAL CORPORATION

Practice address

10362 Bolsa Ave Ste 100
Westminster, CA 92683-6763

Phone

(714) 775-5690

Fax

(714) 775-7405

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Co D.L. Pham, M.D.NPI 1558392159

Title

President

Phone

(714) 775-5690

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Bolsa Outpatient Surgery Center a Medical CorporationCCN 05C0001389

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Co Dang Long Pham, MD

  • Obstetrics & Gynecology Physician
  • Westminster, CA
  • NPI 1558392159
  NPD (past) Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499904000000",
    "number": "1962500454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10362 BOLSA AVE STE 100",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836763",
            "telephone_number": "714-775-5690",
            "fax_number": "714-775-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10362 BOLSA AVE STE 100",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836763",
            "telephone_number": "714-775-5690",
            "fax_number": "714-775-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLSA OUTPATIENT SURGERY CENTER A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-07-13",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "CO",
        "authorized_official_middle_name": "D.L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-775-5690",
        "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": []
}

• Boi Bui Trinh & Tu Duc Pham PTR
• Bolsa Care Pharmacy Inc
• Bolsa Express Pharmacy, Inc.
• Bolsa Medical Group
• Bolsa Medical Group
• Bryce Caleb Bonilla-Haenn, LPCC
• Boyd J Joyer Jr DDS Inc
• Matthew Robert Brady, PSY.D.
• William Patrick Brake Jr., D.D.S.
• Brian Huy Thai, DMD, PC

• Ambulatory Surgical Clinic/Center in Westminster, CA
• Providers in Westminster, 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 Jul 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.