Bodyby Ultimate LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

BODYBY ULTIMATE LLC

Practice address

2777 Pacific Ave Suite I
Long Beach, CA 90806

Phone

(562) 336-1511

Fax

(562) 336-1510

NPI assigned

Aug 20, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Hyder Mukadam Sr., M.D.

Title

Medical Director

Phone

(562) 336-1511

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1073346789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 PACIFIC AVE SUITE I",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90806",
            "telephone_number": "562-336-1511",
            "fax_number": "562-336-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 PACIFIC AVE SUITE I",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90806",
            "telephone_number": "562-336-1511",
            "fax_number": "562-336-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODYBY ULTIMATE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "MUKADAM",
        "authorized_official_first_name": "HYDER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "562-336-1511",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Lynne Boblak
• Myeshia Bobo, LCSW
• Paul T Bochary, RADT
• Body Philosophy Spa
• Shalanda Body
• Daniel John Boehne, D.D.S.
• Mariana Boekes
• Teaubias Harold Boesch, R.N., F.A.
• Thomas Boetto
• Barbara Ann Bogdan Brosler, RN

• Plastic and Reconstructive Surgery Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.