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General NPI Number Information
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NPI Number | 1285075838
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Entity Type | Organization
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Legal Business Name | L. STEPHEN VAUGHAN, D.D.S., M.D. INC
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Dates
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Enumeration Date | 07/11/2013
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Last Update Date | 05/04/2020
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Provider Practice Location Address
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Address Line | 26730 TOWNE CENTRE DR STE 105
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City | FOOTHILL RANCH
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State | CA
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Zip | 92610-2842
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Country | US
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Telephone | 949-297-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 26730 TOWNE CENTRE DR STE 105
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City | FOOTHILL RANCH
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State | CA
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Zip | 92610-2842
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Country | US
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Telephone | 949-297-8880
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Fax | 949-287-8880
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Authorized Official
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Title or Position | OWNER
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Name | DR. LEONARD STEPHEN VAUGHAN
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Credential | D.D.S.,M.D
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Telephone | 949-297-8880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | OMS 61
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License Number State | CA
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