DR. GARY S BELLACK (NPI# 1750442448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750442448 |
| Entity Type | Individual |
| Full Name | DR. GARY S BELLACK |
| Credential | MD |
| Practice Address |
8631 W 3 Street Ste 225 Los Angeles CA 90048 |
| Mailing Address |
8631 W 3rd Street #225 Los Angeles CA 90048 |
| Practice Telephone | 3106593938 |
| Practice Fax Number | 3106594231 |
| Mailing Telephone | 3106593938 |
| Mailing Fax Number | 3106594231 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-05-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
C42325 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00C423250 | 05 |
| Street Address |
8631 W 3 STREET STE 225 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1760090062 | New Dawn Tms Psychiatry | Clinic/Center | 640 S San Vincente Blvd, Ste. 210, Los Angeles, CA 90048 | 2020-07-22 |
| 1114547312 | Savannah Marie Gonzales | Student in an Organized Health Care Education/Training Program | 8700 Beverly Blvd Suite 3636, Los Angeles, CA 90048 | 2020-04-17 |
| 1861048613 | Sam Dawkins | Internal Medicine | Suite 415e, 8631 West Third Street, Los Angeles, CA 90048 | 2019-08-16 |
| 1295202638 | Caleb Rogers Penn | Anesthesiology | Cedars-sinai Department of Anesthesiology, 8700 Beverly Blvd, Los Angeles, CA 90048 | 2018-10-24 |
| 1437641727 | Medical Imaging Center of Southern California-beverly Hills, Inc | Radiology | 8727 Beverly Blvd, Los Angeles, CA 90048 | 2018-06-01 |
| 1689164121 | Maulin Shah | Student in an Organized Health Care Education/Training Program | 8700 Beverly Blvd Suite 5512, Los Angeles, CA 90048 | 2018-05-10 |
| 1013423631 | Abdul Ali Qaderi | Anesthesiology | 8700 Beverly Blvd Suite 4209, Los Angeles, CA 90048 | 2017-12-19 |
| 1619483559 | Sakeenah Hakim | Social Worker | 292 S. La Cienega Blvd, Suite 102, Los Angeles, CA 90048 | 2017-12-14 |
| 1851805048 | West Hollywood Medical Group Inc | General Practice | 8733 Beverly Blvd Suite #203, West Hollywood, CA 90048 | 2017-11-27 |
| Find all providers in zip 90048 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist 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 surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770041881 | Robotic Brain and Spine Institute Inc | Otolaryngology | 9201 W Sunset Blvd Ste 405, Los Angeles, CA 90069-3705 | 2019-03-07 |
| 1275784233 | Stephen Wayne Hargett | Otolaryngology | 1200 North State St., Los Angeles, CA 90033 | 2008-10-08 |
| 1134410038 | Jonathan Mallen-st. Clair | Otolaryngology | 10833 Le Conte Ave, 72-235, Los Angeles, CA 90095-1749 | 2011-04-26 |
| 1033411970 | K C Salkinder Md, Inc | Otolaryngology | 6221 Wilshire Blvd, Suite 318, Los Angeles, CA 90048-5201 | 2010-11-29 |
| 1245413103 | Ann Marie Visosky | Otolaryngology | 6041 Cadillac Ave, Los Angeles, CA 90034-1702 | 2007-12-13 |
| 1073707212 | Benjamin William Walline | Otolaryngology | 2080 Century Park E, #610, Los Angeles, CA 90067-2001 | 2007-08-30 |
| 1699829762 | Baldev Krishan Devgan | Otolaryngology | 11735 W Washington Blvd, Suite # 101, Los Angeles, CA 90066-5917 | 2007-01-23 |
| 1811045891 | Tasia S. Economou | Otolaryngology | 6041 Cadillac Ave, Los Angeles, CA 90034-1702 | 2007-01-08 |
| 1609943513 | Michael P. Mc Nicoll | Otolaryngology | 4733 W Sunset Blvd, Los Angeles, CA 90027-6021 | 2006-11-29 |
| 1326115320 | Craig F. Ingber | Otolaryngology | 6041 Cadillac Ave, Los Angeles, CA 90034-1702 | 2006-11-29 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90048 |
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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.