PLASTIC AND RECONSTRUCTIVE CARE, LLC (NPI# 1962979484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962979484 |
| Entity Type | Organization |
| Organization Name | PLASTIC AND RECONSTRUCTIVE CARE, LLC |
| Practice Address |
9735 Wilshire Blvd Ph Beverly Hills CA 90212-2104 |
| Mailing Address |
3505 Alma Ave Manhattan Beach CA 90266-3330 |
| Practice Telephone | 3108608915 |
| Mailing Telephone | 3108016741 |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2019-03-05 |
| Authorized Official Name | MR. MIKE ROMAGNOLI (MANAGER) |
| Authorized Official Telephone | 3108016741 |
| Is Organization Subpart | Y |
| Parent Organization Name | LEIF L. ROGERS, MD,LLC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities | ||
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
9735 WILSHIRE BLVD PH |
| City | BEVERLY HILLS |
| State | CA |
| Zip Code | 90212-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518131747 | Harold Allen Lancer | Specialist | 9735 Wilshire Blvd Ph, Beverly Hills, CA 90212-2104 | 2008-04-18 |
| 1932677796 | Rand Alan Rusher | Registered Nurse | 9735 Wilshire Blvd Ph, Beverly Hills, CA 90212-2104 | 2018-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629535604 | Diego Bautista | Specialist/Technologist, Other | 324 S Beverly Drive #214, Beverely Hills, CA 90212 | 2019-02-26 |
| 1124582978 | California Surgery of Excellence, LLC | Clinic/Center | 269 S Beverly Dr Ste 809, Beverly Hills, CA 90212 | 2019-01-25 |
| 1356818132 | Kari Michelle Sacks | Social Worker | 300 South Beverly Drive, Beverly Hills, CA 90212 | 2018-10-30 |
| 1942782370 | Susan Elizabeth Smiley | Technician, Other | 160 S. Lasky Drive, Beverly Hills, CA 90212 | 2018-09-01 |
| 1417443714 | Sharona Asal Mossazadeh | Physician Assistant | 344 S Rodeo Dr, Beverly Hills, CA 90212 | 2018-07-10 |
| 1760983167 | Nina Rebecca Moradi | Marriage & Family Therapist | 420 S. Beverly Dr., Suite 100-19, Beverly Hills, CA 90212 | 2018-02-22 |
| 1376065946 | Rebecca Shelly Agi | Lactation Consultant, Non-RN | 350 South Reeves Dr., 201, Beverly Hills, CA 90212 | 2017-07-14 |
| 1952853582 | Dmarkis Randolph | Dietetic Technician, Registered | 269 S Beverly Drive, 1038, Beverly Hills, CA 90212 | 2016-10-31 |
| 1023560935 | Barrence Baytos | Kinesiotherapist | 260 S. Beverly Drive, Suite # 210, Beverly Hills, CA 90212 | 2016-10-26 |
| 1467810424 | Laura Fischer | Registered Nurse | 120 S Spalding Dr Ste 301, Beverly Hills, CA 90212 | 2016-02-05 |
| Find all providers in zip 90212 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699382523 | Beverly Hills Outpatient Surgery Center Inc | Surgery | 50 N La Cienega Blvd Ste 203, Beverly Hills, CA 90211-2246 | 2020-09-24 |
| 1619355757 | Justin E Rome Md PC | Surgery | 256 S La Cienega Blvd, Beverly Hills, CA 90211-3302 | 2015-05-08 |
| 1124140355 | Gabriel Ham-chang Chiu Jr. | Surgery | 9454 Wilshire Blvd, Ground Floor #108, Beverly Hills, CA 90212-2929 | 2007-04-06 |
| 1346371929 | Dennis Dass | Surgery | 8929 Wilshire Blvd Ste 420, Beverly Hills, CA 90211-1953 | 2007-03-08 |
| 1891854915 | Ryan Andrew Stanton | Surgery | 9090 Burton Way, Beverly Hills, CA 90211 | 2006-12-06 |
| 1144301748 | Farid Afra | Surgery | 450 Trousdale Pl, Beverly Hills, CA 90210-1904 | 2006-10-18 |
| 1467076885 | Amy Maria York | Surgery | 436 N Bedford Dr Ste 103, Beverly Hills, CA 90210-4323 | 2020-06-01 |
| 1053960591 | Samer Alnajjar, M.d., Inc. | Surgery | 465 N Roxbury Dr Ste 1020, Beverly Hills, CA 90210-4213 | 2019-09-07 |
| 1861979288 | Cassileth Recontructive Surgeons, Inc | Surgery | 436 N Bedford Dr Ste 103, Beverly Hills, CA 90210-4323 | 2018-07-27 |
| 1265920672 | Andrew T Cohen A Medical Corporation | Surgery | 9400 Brighton Way Ste 201, Beverly Hills, CA 90210-4709 | 2018-05-01 |
| Find all providers in BEVERLY HILLS | ||||
| City | BEVERLY HILLS |
| Zip Code | 90212 |
Please comment or provide details below to improve the information on PLASTIC AND RECONSTRUCTIVE CARE, LLC.
| 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.