FULLERTON SURGICAL CENTER
NPI 1962423574
Clinic/Center - Ambulatory Surgical in Fullerton, CA

NPI Status: Active since July 21, 2006

Contact Information

2240 NORTH HARBOR BLVD.
SUITE 100
FULLERTON, CA
ZIP 92835
Phone: (714) 870-8300
Fax: (714) 870-8301

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 05D1027424
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 06-28-2026

About FULLERTON SURGICAL CENTER

This page provides the complete NPI Profile along with additional information for Fullerton Surgical Center, a provider established in Fullerton, California operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1962423574 assigned on July 2006. The practitioner's primary taxonomy code is 261QA1903X with license number 550000031 (CA). The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Fullerton Surgical Center. The authorized official of this NPI record is Mr. Phillip A Clendenin (President Of Lp)

NPI
1962423574
Provider Legal Name
FULLERTON SURGICAL CENTER, LP
Other Organization Name
FULLERTON SURGICAL CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2240 NORTH HARBOR BLVD. SUITE 100 FULLERTON, CA 92835
Location Phone
(714) 870-8300
Location Fax
(714) 870-8301
Mailing Address
20 BURTON HILLS BLVD. SUITE 500 ATTN: L&C NASHVILLE, TN 37215
Mailing Phone
(615) 240-3820
Mailing Fax
(714) 870-8301
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-21-2006
Last Update Date
09-07-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
550000031
License State
CA

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. PHILLIP A CLENDENIN

Authorized Official Title
PRESIDENT OF LP
Authorized Official Phone
(615) 665-1283

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Crushing of stone of ureter with insertion of stent using an endoscope

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

This service was performed 16 times for 12 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 31 times for 18 patients

Imaging of urinary tract following injection of a contrast agent

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

This service was performed 13 times for 13 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 43 times for 26 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 19 times for 17 patients

Insertion of sacral nerve neurostimulator electrode array

The insertion of a sacral nerve neurostimulator electrode array is a procedure where a small device is placed under your skin. This device sends mild electrical pulses to your sacral nerves, which can help manage certain body functions and alleviate symptoms.

This service was performed 29 times for 14 patients

Insertion of spinal neurostimulator electrode array through skin

This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.

This service was performed 39 times for 14 patients

Insertion of spinal neurostimulator generator or receiver

The insertion of a spinal neurostimulator generator or receiver is a procedure to manage chronic pain. A small device is implanted under your skin, which sends mild electrical signals to your spinal cord. These signals disrupt pain signals, helping to reduce discomfort.

This service was performed 12 times for 12 patients

Shock wave crushing of kidney stones

Shock wave crushing of kidney stones, also known as Extracorporeal Shock Wave Lithotripsy (ESWL), is a non-invasive treatment. It involves the use of sound waves to break down kidney stones into small pieces that can easily pass through your urinary tract.

This service was performed 15 times for 15 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D1027424
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
June 29, 2024
Certificate Expiration Date
June 28, 2026
Laboratory Director
KAVEH MATIN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Fullerton Surgical Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1962423574, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
2
Unchanged
Pos 5
4
Doubled → 8
Pos 6
2
Unchanged
Pos 7
3
Doubled → 6
Pos 8
5
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 4 → 8 3 → 6 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 1 + 2 + 2 + 8 + 2 + 6 + 5 + 1 + 4 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1962423574.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1962423574, enumerated as an "organization" on July 21, 2006.

The provider is located at 2240 NORTH HARBOR BLVD. SUITE 100 FULLERTON, CA 92835 and the phone number is (714) 870-8300.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.