DR. DOUGLAS L HENDRICKS (NPI# 1922165703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922165703 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS L HENDRICKS |
| Other Name | DR. DOUGLAS L HENDRICKS |
| Credential | MD |
| Practice Address |
280 Newport Center Dr Suite 120 Newport Beach CA 92660-7526 |
| Practice Telephone | 9496409570 |
| Practice Fax Number | 9496409569 |
| Mailing Telephone | 9496409570 |
| Mailing Fax Number | 9496409569 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | G069421 | CA | Allopathic & Osteopathic Physicians |
| N | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
G069421 | CA | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 036151135 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036151135 | 05 | |
| WI | 1922165703 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7402 E Riverside Blvd, Loves Park, IL 611115630 | 8159713920 | 8152269672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700878824 | Douglas J Hendricks | Physical Medicine & Rehabilitation | 5320 West Michaels Drive, Appleton, WI 54913 | 2005-08-16 |
| Street Address |
280 NEWPORT CENTER DR SUITE 120 |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92660-7526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043249808 | Farzan Shabbir Rajput | Internal Medicine | 280 Newport Center Dr, Suite 110, Newport Beach, CA 92660-7526 | 2006-07-02 |
| 1013458975 | Pacifica Cosmetic Surgery Center, A Medical Corp | Clinic/Center | 280 Newport Center Dr, Suite 120, Newport Beach, CA 92660-7526 | 2017-03-13 |
| 1881097095 | Wave Imaging LLC | Clinic/Center | 280 Newport Center Dr, Suite 100, Newport Beach, CA 92660-7526 | 2014-10-01 |
| 1518270503 | Farzan S. Rajput, Md Inc | Internal Medicine | 280 Newport Center Dr, Suite 110, Newport Beach, CA 92660-7526 | 2010-07-19 |
| 1871813915 | Sarah K Kwon | Acupuncturist | 280 Newport Center Dr, 200, Newport Beach, CA 92660-7526 | 2010-06-10 |
| 1104065523 | Kelly Eunjoo Kim | Acupuncturist | 280 Newport Center Dr, Suite 200, Newport Beach, CA 92660-7526 | 2009-02-09 |
| 1437322237 | Coastal Counseling & Coaching, Inc | Community/Behavioral Health | 280 Newport Center Dr, Suite 200, Newport Beach, CA 92660-7526 | 2008-04-11 |
| 1659496404 | James William Correa | Dentist | 280 Newport Center Dr, #230, Newport Beach, CA 92660 | 2007-03-20 |
| 1639219694 | Kathleen Anne Nickerson | Psychologist | 280 Newport Center Dr, Suite 200, Newport Beach, CA 92660-7526 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275144024 | Lumins Aesthetic and Wellness, Inc | Dermatology | 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 | 2020-08-14 |
| 1205445798 | Felecia A Pedrogo | Marriage & Family Therapist | 5020 Campus Street, Newport Beach, CA 92660 | 2020-07-30 |
| 1649898388 | Polyviou Dental Corportation, Inc. | Clinic/Center | 120 Newport Beach Drive, Suite 27, Newport Beach, CA 92660 | 2020-07-09 |
| 1154974525 | Jan M. Eckermann, Md Inc. | Neurological Surgery | 1617 W Cliff Dr, Ste 203, Newport Beach, CA 92660 | 2019-07-24 |
| 1235792219 | Horizon Dermatology and Laser Institute | Dermatology | 369 San Miguel Dr. Suite 200, Newport Beach, CA 92660 | 2019-04-16 |
| 1902366925 | Yasmine Central Gohar | Marriage & Family Therapist | 20271 Sw Birch St Ste 200, Newport Beach, CA 92660 | 2019-03-25 |
| 1245703255 | Charison Counseling | Counselor | 4000 Macarthur Bvd Suite 600 East Tower, Newport Beach, CA 92660 | 2019-01-03 |
| 1134698996 | Amber Werner | Chiropractor | 4029 Westerly Place, Suite #115, Newport Beach, CA 92660 | 2018-11-21 |
| 1861969008 | Healthy Me Oc | Dietitian, Registered | 4569 Macarthur Court, Suite 1100, Newport Beach, CA 92660 | 2018-10-25 |
| 1174015192 | Edwin Enwia | Clinic/Center | 1000 Bristol St N Ste 1b, Newport Beach, CA 92660 | 2018-06-05 |
| Find all providers in zip 92660 | ||||
| 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 |
|---|---|---|---|---|
| 1700405586 | Keyian Paydar, Md, PC | Plastic Surgery | 3991 Macarthur Blvd Ste 320, Newport Beach, CA 92660-3004 | 2020-04-13 |
| 1619491206 | Crystal Osborn | Plastic Surgery | 4501 Birch St Ste B, Newport Beach, CA 92660-1928 | 2017-07-26 |
| 1982032009 | Pacific Cosmetic and Facelift Center Inc. | Plastic Surgery | 1601 Dove St Ste 125, Newport Beach, CA 92660-1419 | 2013-10-29 |
| 1336405752 | Donald Stewart Mowlds Jr. | Plastic Surgery | 1441 Avocado Ave Ste 203, Newport Beach, CA 92660 | 2012-04-10 |
| 1679848246 | Thomas Walter Barnes | Plastic Surgery | 1441 Avocado Avenue #207, Newport Beach, CA 92660 | 2012-03-15 |
| 1316242647 | Brian P. Dickinson, M.d., Inc | Plastic Surgery | 351 Hospital Rd Ste 305, Newport Beach, CA 92663-3505 | 2011-01-18 |
| 1821324682 | Terry J. Dubrow A Medical Corp | Plastic Surgery | 1617 Westcliff Dr Ste 100, Newport Beach, CA 92660-5525 | 2009-10-28 |
| 1295965440 | Aisthetikos, Inc | Plastic Surgery | 1501 Superior Avenue, Suite 303, Newport Beach, CA 92663-3641 | 2009-07-22 |
| 1134315930 | James H. Rosing | Plastic Surgery | 1441 Avocado Ave Ste 708, Newport Beach, CA 92660-7708 | 2007-09-14 |
| 1386848984 | Angela Ferguson Champion | Plastic Surgery | 2121 San Joaquin Hills Rd, Newport Beach, CA 92660-6507 | 2007-06-14 |
| Find all providers in NEWPORT BEACH | ||||
| City | NEWPORT BEACH |
| Zip Code | 92660 |
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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.