Organization
SADDLEBACK VALLEY SURGICAL-MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE HANSEN (BUS ADMIN)
(949) 364-1007
Entity
Organization
Contact information
Practice address
26732 CROWN VALLEY PKWY, SUITE 351, MISSION VIEJO, CA 92691-6306
(949) 364-1007
(949) 364-0317
Mailing address
26732 CROWN VALLEY PKWY, SUITE 351, MISSION VIEJO, CA 92691-6306
(949) 364-1007
(949) 364-0317
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
W1452
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ71131Z
—
CA
Enumeration date
07/28/2005
Last updated
07/15/2010
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