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FOOTHILL SURGICAL INSTITUTE, LLC
NPI 1104985910
Clinic/Center - Ambulatory Surgical in Lake Forest, CA

Active since December 07, 2006CLIA 05D1030512 · Waiver
29300 PORTOLA PKWY, SUITE A, LAKE FOREST, CA 92630(949) 367-1006 Get Directions Write a Review

NPPES record last updated: September 14, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Foothill Surgical Institute, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOOTHILL SURGICAL INSTITUTE, LLC (NPI 1104985910) is a healthcare organization registered as an ambulatory surgical in Lake Forest, California and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through September 7, 2026 and lists Nazli Arefkia, Ceo, as its authorized official.

NPPES Registry Identity

NPI1104985910
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameFOOTHILL SURGICAL INSTITUTE, LLC
Location Address29300 PORTOLA PKWY, SUITE ALake Forest, CA 92630-8718
Mailing Address29300 Portola Pkwy Ste ALake Forest, CA 92630-8741 · (949) 367-1006
Phone(949) 367-1006
Organization SubpartNo
Authorized OfficialNazli ArefkiaCeo · (949) 510-0951
Enumeration DateDecember 7, 2006
Last NPPES UpdateSeptember 14, 2023
NPPES CertifiedSeptember 14, 2023
✔ NPI 1104985910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
29300 PORTOLA PKWY, Lake Forest, CA 92630
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1030512

Foothill Surgical Institute · Lake Forest, CA
Active · expires Sep 7, 2026
CLIA Number05D1030512
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateSeptember 8, 2024
Certificate Expiration DateSeptember 7, 2026
Laboratory DirectorKevin Burns
Laboratory Phone(949) 484-7222
Laboratory LocationFoothill Surgical Institute29300 Portola Parkway Ste A, Lake Forest, CA 92630
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEAVENLY PLASTIC SURGERY, PC
Surgery (Plastic and Reconstructive Surgery)
29300 PORTOLA PKWY
LAKE FOREST, CA 92630
Orange County (657) 333-5497
PORTOLA ANESTHESIA SERVICES LLC
Clinic/Center (Medical Specialty)
29300 PORTOLA PKWY, SUITE B
LAKE FOREST, CA 92630
Orange County (949) 837-3338
RICHARD R MOY DPM
Podiatrist (Foot & Ankle Surgery)
29300 PORTOLA PKWY, SUITE B
LAKE FOREST, CA 92630
Orange County (949) 837-3338

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Foothill Surgical Institute, LLC's NPI number?

The NPI number for Foothill Surgical Institute, LLC is 1104985910. It was assigned to this organization in the NPPES registry on December 7, 2006.

Where is Foothill Surgical Institute, LLC located?

Foothill Surgical Institute, LLC is located at 29300 Portola Pkwy Suite A, Lake Forest, CA 92630. The listed phone number is (949) 367-1006.

What is Foothill Surgical Institute, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Foothill Surgical Institute, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1030512) is associated with this NPI, valid through September 7, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Foothill Surgical Institute, LLC was last updated on September 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.