The Regents of the University of California

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

THE REGENTS OF THE UNIVERSITY OF CALIFORNIA

Practice address

200 Medical PLZ
Suite 465
Los Angeles, CA 90095-0001

Phone

(310) 825-5510

Fax

(310) 301-8751

NPI assigned

Apr 19, 2006

Organization subpart

No

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

Authorized official

Name

Marcia Morrissey

Title

Executive Administrator

Phone

(310) 825-5318

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• UCLA Plastic SUrgery Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 33

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

• Christopher Arthur Crisera

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1306850763
  Medicare reassignment Care Compare group NPD
• Andrew Louis Da Lio, MD

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1437163334
  Medicare reassignment Care Compare group NPD
• Michael Delong, MD

  • Plastic Surgery Physician
  • Los Angeles, CA
  • NPI 1104246339
  Medicare reassignment Care Compare group NPD
• Nicholas Thu Khoa DO

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1659666014
  Medicare reassignment Care Compare group NPD
• Jaco Hagop Festekjian, MD

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1619981073
  Medicare reassignment Care Compare group NPD
• Reza Jarrahy, MD, FACS, FAAP

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1407956816

  Plastic Surgery

  Medicare reassignment Care Compare group NPD
• Justine C Lee, MD, PHD

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1285883835
  Medicare reassignment Care Compare group NPD
• Edward Haig Nahabet

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1073976874
  Medicare reassignment Care Compare group NPD
• Jason Roostaeian, M.D.

  • Plastic Surgery Physician
  • Los Angeles, CA
  • NPI 1346491552
  Medicare reassignment Care Compare group NPD
• George Henry Rudkin, MD

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1508870403
  Medicare reassignment Care Compare group NPD
• Ginger C Slack

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1811330566
  Medicare reassignment Care Compare group NPD
• Chia Soo, MD

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
  • NPI 1114959822
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1164487518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455632",
            "telephone_number": "310-301-8708",
            "fax_number": "310-301-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLZ",
            "address_2": "SUITE 465",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-5510",
            "fax_number": "310-301-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "MORRISSEY",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "310-825-5318"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0067460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCLA Plastic SUrgery Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Practice of Medicine, Inc
• The Practice West Coast Licensed Clinical Social Worker Inc
• The Regents of the University of California
• The Regents of the University of California
• The Regents of the University of California
• The Regents of the University of California
• The Regents of the University of California
• The Regents of the University of California
• The Regents of the University of California
• The Regents of the University of California

• Plastic Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, 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 Oct 24, 2019; 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.