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PACIFICA COSMETIC SURGERY CENTER A MEDICAL CORP NPI 1013458975


NPI Information

NPI: 1013458975
Provider Name: PACIFICA COSMETIC SURGERY CENTER, A MEDICAL CORP
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
280 NEWPORT CENTER DR
SUITE 120
NEWPORT BEACH, CA
ZIP 92660
Phone: (949) 640-9570
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PACIFICA COSMETIC SURGERY CENTER, A MEDICAL CORP is a health service clinic center in Newport Beach, CA. PACIFICA COSMETIC SURGERY CENTER, A MEDICAL CORP NPI is 1013458975. The provider is registered as an organization entity type.

The provider's business location address is:

280 NEWPORT CENTER DR
SUITE 120
NEWPORT BEACH, CA
ZIP 92660-526
Phone: (949) 640-9570
Fax: (949) 640-9569

The provider's authorized official is Douglas L Hendricks .
The authorized official title is Owner-ceo and has the following contact phone number (949) 640-9570.

The enumeration date for this NPI number is 3/13/2017 and was last updated on 3/13/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QH0100XClinic/CenterHealth Service28839CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11922165703OTHERCALIFORNIANPI OF PROVIDER
200G69421MEDICARE PINCALIFORNIA
3E57869MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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