SOCAL FACIAL PLASTIC SURGERY INC NPI 1346192622

NPI Information

  • NPI: 1346192622
  • Provider Name: SOCAL FACIAL PLASTIC SURGERY, INC
  • Classification: Otolaryngology - 207YS0123X
  • Specialization: Facial Plastic Surgery
  • Entity Type: Organization
  • Address: 6800 INDIANA AVE STE 280
    RIVERSIDE, CA
    ZIP 92506
  • Phone: (304) 881-3170

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NPI Details

SOCAL FACIAL PLASTIC SURGERY, INC is a facial plastic surgery otolaryngology in Riverside, CA. The provider is an otolaryngologist who specializes in facial plastic surgery. SOCAL FACIAL PLASTIC SURGERY, INC NPI is 1346192622. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6800 INDIANA AVE STE 280
RIVERSIDE, CA
ZIP 92506-205
Phone: (304) 881-3170

The provider's authorized official is Adeeb Derakhshan .
The authorized official title is Surgeon and has the following contact phone number (951) 783-9198.

The enumeration date for this NPI number is 2/10/2026 and was last updated on 2/13/2026.

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
1207YS0123XOtolaryngologyFacial Plastic SurgeryYes

What is NPI?

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This page was last updated on: 11/21/2025

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