Organization
UNIV HEAD & NECK SURGEON
Active
Parent organization
UNIVERSITY HEAD & NECK SURGERY
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY HEAD & NECK SURGERY
Authorized official
ALICIA TRAKTMAN AUD (AUDIOLOGIST)
(714) 456-3083
Entity
Organization
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-7017
Mailing address
PO BOX 513700, LOS ANGELES, CA 90051-3700
(714) 456-6655
(714) 456-2280
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
AU1556
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GAU000750
—
CA
Enumeration date
12/04/2007
Last updated
12/04/2007
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