Ryan Matthew Spivak, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

A113632 Issued in CA

Practice address

3680 E Imperial Hwy Ste 502
Lynwood, CA 90262-2661

Phone

(310) 905-3331

NPI assigned

Aug 13, 2010

Last updated

May 8, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrative Medical Group, Inc

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1003369380
  Authorized official Same address or phone
• Integrative Medical Group, Inc., a Professional Corporation

  • Plastic Surgery Physician
  • Los Angeles, CA
  • NPI 1013364397
  Authorized official Same address or phone
• Ryan Spivak Integrative Plastic Surgery Inc

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1841659042
  Authorized official Same address or phone

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1093020018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 46666",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900460666",
            "telephone_number": "310-739-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 E IMPERIAL HWY STE 502",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622661",
            "telephone_number": "310-905-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVAK",
        "first_name": "RYAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-13",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A113632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern California Health & Rehabilitation Program
• Southern California Health & Rehabilitation Program
• Southern California Health & Rehabilitation Program
• Ian Spencer, MFT
• Keshanna Rayann Spencer
• Jose Spiwak, M.D.
• Dionne Springer
• St Francis Medical Center
• St Francis Medical Center
• St Francis Medical Center Gas, Inc

• Plastic and Reconstructive Surgery Physician in Lynwood, CA
• Providers in Lynwood, 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 May 8, 2018; 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.