Organization
HEAD AND NECK ASSOCIATES OF ORANGE COUNTY AN INCORPRATE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN S SUPANCE M.D. (PRESIDENT)
(949) 364-4361
Entity
Organization
Contact information
Practice address
26726 CROWN VALLEY PKWY, #200, MISSION VIEJO, CA 92691-8003
(949) 364-4361
(949) 364-4495
Mailing address
26726 CROWN VALLEY KWY, #200, MISSION VIEJO, CA 92691-8003
(949) 364-4361
(949) 364-4495
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR006970
—
CA
05
—
GR0069701
—
CA
05
—
GR006971
—
CA
Enumeration date
06/18/2006
Last updated
11/21/2014
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