BOLSA OUTPATIENT SURGERY CENTER A MEDICAL CORPORATION
NPI 1962500454
Clinic/Center - Ambulatory Surgical in Westminster, CA

Q: What is Bolsa Outpatient Surgery Center A Medical Corporation's specialty?

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

Active since September 20, 2006CLIA 05D1006732 · Waiver

10362 BOLSA AVE STE 100, WESTMINSTER, CA 92683(714) 775-5690(714) 775-7405 Get Directions Write a Review

NPPES record last updated: July 13, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Bolsa Outpatient Surgery Center A Medical Corporation NPPES

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

BOLSA OUTPATIENT SURGERY CENTER A MEDICAL CORPORATION (NPI 1962500454) is a healthcare organization registered as an ambulatory surgical in Westminster, California and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through May 1, 2028 and lists Co D.l. Pham, President, as its authorized official.

NPPES Registry Identity

NPI1962500454

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameBOLSA OUTPATIENT SURGERY CENTER A MEDICAL CORPORATION

Location Address10362 BOLSA AVE STE 100Westminster, CA 92683-6763

Mailing Address10362 Bolsa Ave Ste 100Westminster, CA 92683-6763 · (714) 775-5690 · Fax (714) 775-7405

Phone(714) 775-5690

Fax(714) 775-7405

Organization SubpartNo

Authorized OfficialCo D.l. PhamPresident · (714) 775-5690

Enumeration DateSeptember 20, 2006

Last NPPES UpdateJuly 13, 2017

✔ NPI 1962500454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

10362 BOLSA AVE STE 100, Westminster, CA 92683

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Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bolsa Outpatient Surgery Center A Medical Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateCaliforniaEnrollment IDO20120608000132Non-DME Part B · Ambulatory Surgical CenterDue dateFebruary 28, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

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 05D1006732

Bolsa Outpatient Surgery Center A Medical Corporation · Westminster, CA

Active · expires May 1, 2028

CLIA Number05D1006732

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateMay 2, 2026

Certificate Expiration DateMay 1, 2028

Laboratory DirectorDzu Tran

Laboratory Phone(714) 775-5690

Laboratory LocationBolsa Outpatient Surgery Center A Medical Corporation10362 Bolsa Ave #100, Westminster, CA 92683

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

114 services104 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

53 services53 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

33 services33 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

27 services27 patients

Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye 66991

This is a two-part eye procedure. First, a cloudy lens (cataract) is removed from its outer layer and replaced with an artificial lens to improve vision. Second, a drainage device is inserted into the front part of the eye to manage fluid levels, preventing pressure build-up.

24 services22 patients

Complex removal of cataract with insertion of prosthetic lens 66982

This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.

17 services16 patients

Other Providers at the Same Location NPPES 2

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

MS. EMILY DAO NGUYEN MD

Pediatrics

10362 BOLSA AVE STE 100
WESTMINSTER, CA 92683

Orange County (714) 531-2091

TRUNG HUU LY MD

Internal Medicine

10362 BOLSA AVE STE 100
WESTMINSTER, CA 92683

Orange County (714) 531-0230

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 Bolsa Outpatient Surgery Center A Medical Corporation's NPI number?

The NPI number for Bolsa Outpatient Surgery Center A Medical Corporation is 1962500454. It was assigned to this organization in the NPPES registry on September 20, 2006.

Where is Bolsa Outpatient Surgery Center A Medical Corporation located?

Bolsa Outpatient Surgery Center A Medical Corporation is located at 10362 Bolsa Ave Ste 100, Westminster, CA 92683. The listed phone number is (714) 775-5690.

What is Bolsa Outpatient Surgery Center A Medical Corporation's specialty?

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

Is Bolsa Outpatient Surgery Center A Medical Corporation enrolled in Medicare?

Yes. Bolsa Outpatient Surgery Center A Medical Corporation is registered in the Medicare PECOS enrollment system.

When is Bolsa Outpatient Surgery Center A Medical Corporation's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Ambulatory Surgical Center) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Bolsa Outpatient Surgery Center A Medical Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1006732) is associated with this NPI, valid through May 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bolsa Outpatient Surgery Center A Medical Corporation was last updated on July 13, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.