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BLUE PACIFIC AESTHETIC MEDICAL GROUP NPI 1124074059


NPI Information

NPI: 1124074059
Provider Name: BLUE PACIFIC AESTHETIC MEDICAL GROUP
Classification: Plastic Surgery - 2082S0099X
Entity Type: Organization

Specialization: Plastic Surgery Within the Head and Neck

Address:
415 PIER AVE
HERMOSA BEACH, CA
ZIP 90254
Phone: (310) 379-6074
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BLUE PACIFIC AESTHETIC MEDICAL GROUP is a plastic surgery within the head and neck plastic surgery in Hermosa Beach, CA. The provider is a plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them. BLUE PACIFIC AESTHETIC MEDICAL GROUP NPI is 1124074059. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

415 PIER AVE
HERMOSA BEACH, CA
ZIP 90254-820
Phone: (310) 379-6074

The provider's authorized official is Douglas Roy Mest .
The authorized official title is President and has the following contact phone number (714) 347-1010.

The enumeration date for this NPI number is 5/25/2006 and was last updated on 5/4/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12082S0099XPlastic SurgeryPlastic Surgery Within the Head and NeckFNP27928CALIFORNIAYes

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: 11/14/2023

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