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PACIFIC BREAST INSTITUTE MEDICAL GROUP NPI 1619380896


NPI Information

NPI: 1619380896
Provider Name: PACIFIC BREAST INSTITUTE MEDICAL GROUP

Other Name: COSMETIC SURGERY ASSOCIATES MEDICAL GROUP

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
350 VINTON AVE
SUITE 202
POMONA, CA
ZIP 91767
Phone: (909) 629-6417
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PACIFIC BREAST INSTITUTE MEDICAL GROUP is an ambulatory surgical clinic center in Pomona, CA. PACIFIC BREAST INSTITUTE MEDICAL GROUP NPI is 1619380896. The provider is registered as an organization entity type.
The provider Other Name Is Cosmetic Surgery Associates Medical Group.

The provider's business location address is:

350 VINTON AVE
SUITE 202
POMONA, CA
ZIP 91767-000
Phone: (909) 629-6417
Fax: (909) 629-4755

The provider's authorized official is Ossama Deaya Ascha .
The authorized official title is President and has the following contact phone number (909) 629-6417.

The enumeration date for this NPI number is 6/5/2014 and was last updated on 6/5/2014.


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
1261QA1903XClinic/CenterAmbulatory SurgicalA26396CALIFORNIAYes

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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