La Jolla Facial Plastic Surgery Inc

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

A136426 Issued in CA

Legal business name

LA JOLLA FACIAL PLASTIC SURGERY INC

Practice address

4765 Carmel Mountain Rd
Suite 103
San Diego, CA 92130-6657

Phone

(858) 461-0383

Fax

(858) 430-2772

NPI assigned

Sep 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Victor Chung, M.D.NPI 1154551042

Title

President/Director

Phone

(858) 461-0383

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Victor Chung, M.D.

  • Facial Plastic Surgery Physician
  • San Diego, CA
  • NPI 1154551042
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1033587589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4765 CARMEL MOUNTAIN RD",
            "address_2": "SUITE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306657",
            "telephone_number": "858-461-0383",
            "fax_number": "858-430-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 CARMEL MOUNTAIN RD",
            "address_2": "SUITE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306657",
            "telephone_number": "858-461-0383",
            "fax_number": "858-430-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA JOLLA FACIAL PLASTIC SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT/DIRECTOR",
        "authorized_official_telephone_number": "858-461-0383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "A136426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Alvin La Fond, MD
• Joni Dawn La Fuze, OTR/L, CLT
• Nicholas T La Hood, D.C.
• La Jolla Cardiovascular Medical Assoc Inc
• La Jolla Dental Specialty Group
• La Jolla Hospice, Inc.
• La Jolla Orthopaedic Surgery
• La Jolla Orthopedics & Pain Management Center, Inc.
• La Jolla Professional Plastic Surgery
• La Jolla Psychiatric Associates

• Otolaryngology/Facial Plastic Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Otolaryngology/Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.