STANLEY GORDON POULOS (NPI# 1588715015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588715015 |
| Entity Type | Individual |
| Full Name | STANLEY GORDON POULOS |
| Practice Address |
350 Bon Air Road Suite 300 Greenbrae CA 94904 |
| Practice Telephone | 4159252880 |
| Practice Fax Number | 4159252884 |
| Mailing Telephone | 4159252880 |
| Mailing Fax Number | 4159252884 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2008-02-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | G31262 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
350 BON AIR ROAD SUITE 300 |
| City | GREENBRAE |
| State | CA |
| Zip Code | 94904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992816342 | John Richard Manis | Plastic Surgery | 350 Bon Air Road, Suite 300, Greenbrae, CA 94904 | 2006-08-31 |
| 1538365200 | Marc I Schwartz | Psychiatry & Neurology | 350 Bon Air Road, Greenbrae, CA 94904 | 2007-06-21 |
| 1639280001 | Yngvar A Hvistendahl | Plastic Surgery | 350 Bon Air Road, Suite 300, Greenbrae, CA 94904 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295382372 | Stacey Nicole Drew | Occupational Therapist | 4 Ash Ave, Unit 10, Kentfield, CA 94904 | 2019-08-22 |
| 1154781631 | Harvey Sparks | Specialist/Technologist, Other | 350 Bon Air, Ste 100, Greenbrae, CA 94904 | 2016-02-26 |
| 1396120481 | Tamena Potts | Counselor | 1109 Sir Francis Drake, Kentfield, CA 94904 | 2015-07-30 |
| 1598014763 | Rupali Ray Chaudhuri | Nurse Practitioner | 1341 S. Eliseo Dr, Suite 200, Greenbrae, CA 94904 | 2012-09-04 |
| 1326304809 | Lucy Yingxin Zhang | Ophthalmology | 900 S Eliseo Dr Ste 102, Greenbrae, CA 94904 | 2012-04-09 |
| 1396073185 | Bonnie Louise Hoag | Marriage & Family Therapist | 905 Sir Francis Drake Blvd., Ste. F., Kentfield, CA 94904 | 2009-12-07 |
| 1801043880 | Alexander Vogel Uihlein | Internal Medicine | 900 S Eliseo Dr Ste 201, Greenbrae, CA 94904 | 2008-08-21 |
| 1649426115 | Marilyn Thatcher | Psychologist | 1010 Sir Francis Drake Blve, Ste. 103, Kentfield, CA 94904 | 2008-08-14 |
| 1205007598 | Sir Francis Drake Dental | Dentist | 919 Sir Francis Drake Blvd, Kentfield, CA 94904 | 2008-03-14 |
| 1841401734 | Rishi K Wadhwa | Neurological Surgery | 1100 S Eliseo Dr Ste 1, Greenbrae, CA 94904 | 2007-05-24 |
| Find all providers in zip 94904 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760514137 | Roland Takashi Minami | Plastic Surgery | 1240, South Eliseo Dr 102, Greenbrae, CA 94904 | 2007-03-12 |
| 1164500369 | Kimberly Anne Henry | Plastic Surgery | 350 Bon Air Rd Ste 1, Ste 1, Greenbrae, CA 94904-1753 | 2006-11-02 |
| 1992816342 | John Richard Manis | Plastic Surgery | 350 Bon Air Road, Suite 300, Greenbrae, CA 94904 | 2006-08-31 |
| 1174757405 | Kimberly A Henry Md Inc | Plastic Surgery | 350 Bon Air Rd, #1, Greenbrae, CA 94904-1752 | 2009-05-14 |
| 1639280001 | Yngvar A Hvistendahl | Plastic Surgery | 350 Bon Air Road, Suite 300, Greenbrae, CA 94904 | 2006-08-31 |
| 1447278429 | Cynthia M Goodman | Plastic Surgery | 1240 S Eliseo Dr, Ste 201, Greenbrae, CA 94904-2028 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696048 | Victor Liu Md, A Medical Corporation | Plastic Surgery | 1720 El Camino Real Ste 200, Burlingame, CA 94010-3226 | 2020-10-09 |
| 1629683255 | Veritas Aesthetics PC | Plastic Surgery | 23838 Valencia Blvd Ste 260, Valencia, CA 91355-5630 | 2020-09-10 |
| 1700405586 | Keyian Paydar, Md, PC | Plastic Surgery | 3991 Macarthur Blvd Ste 320, Newport Beach, CA 92660-3004 | 2020-04-13 |
| 1548892045 | Adventist Health Physicians Network | Plastic Surgery | 301 Science Dr Ste 180, Moorpark, CA 93021-0800 | 2020-02-12 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1083259840 | Remedy Place Physicians | Plastic Surgery | 8305 Sunset Blvd, Los Angeles, CA 90069 | 2019-11-15 |
| 1851945646 | Skinzone Medical Inc | Plastic Surgery | 3374 S. Bristol St, Santa Ana, CA 92704 | 2019-07-30 |
| 1790341832 | Frederic Jerome Kolb | Plastic Surgery | 200 W Arbor Dr # Mc8890, San Diego, CA 92103-1911 | 2019-05-14 |
| 1588125835 | Beauty Eternal, Inc | Plastic Surgery | 1260 East Ave Ste 130, Chico, CA 95926-1021 | 2019-03-28 |
| 1689131229 | Schoemann Reconstructive Surgery | Plastic Surgery | 477 N El Camino Real Ste D101, Encinitas, CA 92024-1370 | 2019-03-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.