West Bloomfield Aesthetic Surgery Center LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

4301036977 Issued in MI

Legal business name

WEST BLOOMFIELD AESTHETIC SURGERY CENTER LLC

Practice address

31224 Mulfordton St
Suite 210
Farmington Hills, MI 48334-1407

Phone

(247) 538-1998

Fax

(248) 522-6506

NPI assigned

Nov 6, 2009

Organization subpart

No

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

Authorized official

Name

Fanny Dela Cruz, MDNPI 1689742397

Title

Owner

Phone

(248) 539-1009

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Fanny Aguirre Dela Cruz, M.D.

  • Surgery of the Hand (Plastic Surgery) Physician
  • Livonia, MI
  • NPI 1689742397
  NPD (past) Authorized official

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257465600000",
    "number": "1023345345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31224 MULFORDTON ST",
            "address_2": "SUITE 210",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341407",
            "telephone_number": "247-538-1998",
            "fax_number": "248-522-6506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31224 MULFORDTON ST",
            "address_2": "SUITE 210",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341407",
            "telephone_number": "247-538-1998",
            "fax_number": "248-522-6506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST BLOOMFIELD AESTHETIC SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-06",
        "last_updated": "2009-11-06",
        "status": "A",
        "authorized_official_last_name": "DELA CRUZ",
        "authorized_official_first_name": "FANNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-539-1009",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301036977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nyasia Wesley
• Tara Wesolowski
• Todd Wesp
• Ryan Wessell
• Camille Wessels
• West Oakland OBGYN PLLC
• Lakavia West-Martinez
• Barbara J West-Nardicchio, LMSW
• Lashell Tonette West-Ringer, LPC
• Alexis West, RBT

• Plastic Surgery Physician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.