Supance, John Stanley
Supance, John Stanley is an individual health care provider with primary practice located at 26726 Crown Valley Pkwy #200, Mission Viejo CA 92691-6364. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Supance, John Stanley can be contacted via phone (949) 364-4361.Contact Information
Primary practice address
26726 Crown Valley Pkwy #200
Mission Viejo CA 92691-6364
Phone: (949) 364-4361
Fax: (949) 364-4495
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | G50560 | California |
Profile Details
| NPI number | 1194751727 |
|---|---|
| LBN Legal business name | Supance, John Stanley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2006 |
| Last updated | Sep 20th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194751727 | NPPES |
| California | MEDICAID | 00G505600 |
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