PREMIERE SURGICAL SPECIALISTS, A PROFESSIONAL CORPORATION (NPI# 1710319017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710319017 |
| Entity Type | Organization |
| Organization Name | PREMIERE SURGICAL SPECIALISTS, A PROFESSIONAL CORPORATION |
| Practice Address |
35 E Glenarm St Pasadena CA 91105-3418 |
| Mailing Address |
1044 S Fair Oaks Ave Suite 101 Pasadena CA 91105-2622 |
| Practice Telephone | 6267684415 |
| Practice Fax Number | 6264030321 |
| Mailing Telephone | 6264494859 |
| Mailing Fax Number | 6264030321 |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2020-05-01 |
| Authorized Official Name | DR. BRIAN ALLEN COX (PRESIDENT) |
| Authorized Official Telephone | 6264494859 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CITY OF GLENDORA LICENSE | 11713 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 210 S Grand Ave Ste 407, Glendora, CA 917414290 | 6269636026 | 6266582848 |
| Street Address |
35 E GLENARM ST |
| City | PASADENA |
| State | CA |
| Zip Code | 91105-3418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568848042 | Reza Kermani Md Inc | Surgery | 35 E Glenarm St, Pasadena, CA 91105-3418 | 2015-08-06 |
| 1932598364 | Akmd Inc | Surgery | 35 E Glenarm St, Pasadena, CA 91105-3418 | 2015-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619451697 | Tonya Michlin | Registered Nurse | 800 Fairmount Ave Ste 110, Pasadena, CA 91105 | 2018-09-17 |
| 1639674161 | David Marcus Md, Inc. | Psychiatry & Neurology | 107 S. Fair Oaks Avenue, Suite #315, Pasadena, CA 91105 | 2018-03-27 |
| 1548778541 | Elias & Jun Dental Corp | Dentist | 301 S. Fair Oaks Ave., Ste 107, Pasadena, CA 91105 | 2018-01-12 |
| 1013429745 | Whitney Catalano | Dietitian, Registered | 100 S Orange Grove Blvd, 103, Pasadena, CA 91105 | 2017-11-03 |
| 1518485630 | Marlon O Miller | Counselor | 1020 South Arroyo Parkway, Pasadena, CA 91105 | 2017-09-08 |
| 1316469976 | Alexandra Scott | Speech-Language Pathologist | 235 La Vereda Road, Pasadena, CA 91105 | 2017-07-14 |
| 1346770443 | Amanda Grace Gentz | Rehabilitation Practitioner | 210 S De Lacey, Ste 110, Pasadena, CA 91105 | 2017-06-13 |
| 1427598390 | Melina Gomez Loza | Licensed Vocational Nurse | 66 Hilburt St #2, Pasadena, CA 91105 | 2017-02-27 |
| 1588115281 | Ramon Banuelos | Rehabilitation Practitioner | 210 S. Delacey Ave Suite 110, Pasadena, CA 91105 | 2016-10-18 |
| 1922554245 | Daniel Joseph Ybarra | Student in an Organized Health Care Education/Training Program | 100 W. California Blvd. Pasadena, Ca 91105, Pasadena, CA 91105 | 2016-08-28 |
| Find all providers in zip 91105 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780068189 | Pro Surgical Inc | Surgery | 88 N Fair Oaks Ave Ste 105, Pasadena, CA 91103-3655 | 2015-07-15 |
| 1255756524 | Tirso Deljunco Sr. | Surgery | 1010 E. Union St., #130, Pasadena, CA 91106 | 2014-02-24 |
| 1376860346 | Gloria Marie F. Kimie Tumbaga | Surgery | 1294 E Colorado Blvd, Pasadena, CA 91106-1901 | 2010-04-29 |
| 1346417714 | Arthur Joseph Donovan | Surgery | 111 S Orange Grove Blvd Apt 308, Pasadena, CA 91105-1756 | 2008-05-14 |
| 1356549398 | N V Danekar M D A Professional Corporation | Surgery | 3235 Villa Highlands Dr, Pasadena, CA 91107-1537 | 2007-07-10 |
| 1235336033 | David J Lourie Md Inc Wes J Powell Md Inc David R Martin Md Inc | Surgery | 50 Bellefontaine St Ste 404, Pasadena, CA 91105-3132 | 2007-06-27 |
| 1215022561 | Jean Claude Henry | Surgery | 655 S Euclid Ave, Pasadena, CA 91106-3732 | 2006-10-03 |
| 1205879822 | Fernando E Miranda Sr. | Surgery | 4301b Vista Rd, #100, Pasadena, TX 77504-2117 | 2006-06-13 |
| 1013966571 | David J Lourie | Surgery | 950 S Arroyo Pkwy, Fl 3, Pasadena, CA 91105-3930 | 2006-05-10 |
| 1720037807 | David R Martin | Surgery | 955 S Arroyo Pkwy, 3rd Floor, Pasadena, CA 91105 | 2006-05-08 |
| Find all providers in PASADENA | ||||
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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.