Blue Pacific Aesthetic Medical Group

Primary specialty

Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X

License

FNP27928 Issued in CA

Legal business name

BLUE PACIFIC AESTHETIC MEDICAL GROUP

Practice address

415 Pier Ave
Hermosa Beach, CA 90254-3820

Phone

(310) 379-6074

NPI assigned

May 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Roy Mest, M.D.NPI 1578527131

Title

President

Phone

(714) 347-1010

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Douglas Roy Mest, M.D.

  • Anesthesiology Physician
  • Newport Beach, CA
  • NPI 1578527131
  NPD (past) Authorized official
• Heidi M Carle, FNP

  • School Registered Nurse
  • Hermosa Beach, CA
  • NPI 1639667710
  NPD (past)
• Haleigh Foster

  • Family Nurse Practitioner
  • Hermosa Beach, CA
  • NPI 1609754639
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272931200000",
    "number": "1124074059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "800-883-7243",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 PIER AVE",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543820",
            "telephone_number": "310-379-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE PACIFIC AESTHETIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2010-05-04",
        "status": "A",
        "authorized_official_last_name": "MEST",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-347-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "CA",
            "license": "FNP27928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malori Bennett
• Kimberly Bergin, M.S., CCC-SLP
• Caroline Bernstein, LMFT
• Bailey Bettencourt
• Jacqueline S. Bixby
• Michele Lorraine Blume, PSY.D.
• Winnifred Katherine Boeckmann, AMFT
• Rachel Sarah Bogner, LCSW
• Sarah Ashley Bolla, BCBA
• Eloisa Bonilla, LMFT

• Plastic Surgery Physician in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; 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.