Orange Coast Head and Neck Surgery

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

W20172 Issued in CA

Legal business name

ORANGE COAST HEAD AND NECK SURGERY

Practice address

16100 Sand Canyon Ave
Ste 310
Irvine, CA 92618-3716

Phone

(949) 715-0500

Fax

(949) 715-0503

NPI assigned

May 19, 2014

Last updated

May 19, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Laura Renteria

Title

Office Manager

Phone

(949) 715-0500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Orange Coast Head and Neck2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Orange Coast Head and Neck Surgery

  • Otolaryngology Physician
  • Laguna Beach, CA
  • NPI 1457750176
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Ann Pitale, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Mission Viejo, CA
  • NPI 1194843383
  Medicare reassignment Care Compare group NPD
• Eunice Suh, NP

  • Family Nurse Practitioner
  • Tustin, CA
  • NPI 1154184307
  Medicare reassignment Care Compare group NPD
• Robert M Pettis, M.D.

  • Otolaryngology Physician
  • Oskaloosa, IA
  • NPI 1427082346

  CA

  Medicare reassignment Care Compare group NPD
• Nhu Pham, FNP

  • Nurse Practitioner
  • Santa Ana, CA
  • NPI 1912511718
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400457600000",
    "number": "1710398193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16100 SAND CANYON AVE",
            "address_2": "STE 310",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183716",
            "telephone_number": "949-715-0500",
            "fax_number": "949-715-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 SAND CANYON AVE",
            "address_2": "STE 310",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183716",
            "telephone_number": "949-715-0500",
            "fax_number": "949-715-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE COAST HEAD AND NECK SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-19",
        "status": "A",
        "authorized_official_last_name": "RENTERIA",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "949-715-0500"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "W20172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optimum Podiatry Services Inc
• Optimus Spine Center Corp (Optimus Chiropractic)
• Optimus West LLC
• Optumrx
• Orange Coast Family Medical Group Inc.
• Orange Coast Laser Vision Center, Inc.
• Orange County Comprehensive Psychological Services, Inc
• Orange County Digestive Center, Inc
• Orange County Ear, Nose & Throat
• Orange County Family Therapy, Professional Corporation

• Otolaryngology Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.