Orange County Maxillofacial Surgery Center | |
2401 W Chapman Ave Ste 101 Orange CA 92868-2327 | |
(714) 939-7505 | |
Not Available |
Full Name | Orange County Maxillofacial Surgery Center |
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Speciality | Dentist |
Location | 2401 W Chapman Ave Ste 101, Orange, California |
Authorized Official Name and Position | Farzin Farshidi (PRESIDENT) |
Authorized Official Contact | 7149397505 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Orange County Maxillofacial Surgery Center 2401 W Chapman Ave Ste 101 Orange CA 92868-2327 Ph: (714) 939-7505 | Orange County Maxillofacial Surgery Center 2401 W Chapman Ave Ste 101 Orange CA 92868-2327 Ph: (714) 939-7505 |
NPI Number | 1356865422 |
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Provider Enumeration Date | 08/01/2017 |
Last Update Date | 01/20/2022 |
Medicare PECOS PAC ID | 6002181252 |
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Medicare Enrollment ID | O20171013002138 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356865422 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0106X | Dentist - Oral And Maxillofacial Pathology | DDS63573 (California) | Primary |
Provider Name | Farzin S Farshidi |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1750676755 PECOS PAC ID: 2668779752 Enrollment ID: I20171013002379 |
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