Pacifica Cosmetic Surgery Center, a Medical Corp

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

28839 Issued in CA

Legal business name

PACIFICA COSMETIC SURGERY CENTER, A MEDICAL CORP

Practice address

280 Newport Center Dr
Suite 120
Newport Beach, CA 92660-7526

Phone

(949) 640-9570

Fax

(949) 640-9569

NPI assigned

Mar 13, 2017

Organization subpart

Yes

Parent organization

PACIFICA COSMETIC SURGERY CENTER, A MEDICAL CORPAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Douglas L Hendricks, M.D.NPI 1922165703

Title

Owner-Ceo

Phone

(949) 640-9570

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Pacifica Cosmetic Surgery Center a Medical Corp

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Douglas L Hendricks, MD

  • Plastic Surgery Physician
  • Newport Beach, CA
  • NPI 1922165703
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1013458975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 NEWPORT CENTER DR",
            "address_2": "SUITE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607526",
            "telephone_number": "949-640-9570",
            "fax_number": "949-640-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 NEWPORT CENTER DR",
            "address_2": "SUITE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607526",
            "telephone_number": "949-640-9570",
            "fax_number": "949-640-9569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICA COSMETIC SURGERY CENTER, A MEDICAL CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PACIFICA COSMETIC SURGERY CENTER, A MEDICAL CORP",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER-CEO",
        "authorized_official_telephone_number": "949-640-9570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "28839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI OF PROVIDER",
            "identifier": "1922165703",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Shores Recovery LLC
• Pacific Spine and Wellness PC
• Pacific Women'S Healthcare Associaes
• Pacific Women'S Healthcare Associates
• Pacific Women'S Healthcare Associates, Inc.
• Donald L. Pacini, D.C.
• Amber Michelle Packer, RNFA
• Marc Packey, RPSGT, CCSH
• Veronica Paco
• Bethzaida Guadalupe Paez

• Health Service Clinic/Center in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Health Service Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.