Scripps Plastic Surgery Medical Group Inc
Organization Active NPI Plastic Surgery Physician · La Jolla, CA
NPI 1164510350 · NPPES record last updated May 10, 2011
Key facts
- NPI
- 1164510350
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Plastic Surgery Physician 208200000X
- License
- A69572 (CA)
- Legal business name
- SCRIPPS PLASTIC SURGERY MEDICAL GROUP INC
- Practice address
- 9834 Genesee Ave
#311
La Jolla, CA 92037 - Phone
- (858) 458-5100
- Fax
- (858) 458-1550
- NPI assigned
- Oct 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Douglas Glynn Bolitho, MD PHD
- Title
- Owner
- Phone
- (858) 458-5100
Practitioners 2
-
Douglas Glynn Bolitho, M.D.
-
Arash Mozayan Isfahani, M.D.
National Provider Directory
Locations
9834 Genesee Ave
Ste 311
La Jolla, CA 92037
Phone (760) 300-3270
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician |
208200000X | A69572 | CA | Yes |
Addresses
Primary practice location
9834 Genesee Ave
#311
La Jolla, CA 92037
Mailing address
9834 Genesee Ave
#311
La Jolla, CA 92037
Phone (858) 458-5100
Other names
- O Glynn Bolitho
Other providers in La Jolla, CA
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- Scripps Health Inpatient Providers Medical Group Inc.
- Scripps Surgery Center, LLC
- SD Psychology, a Professional Corporation
- SDPM Medical Group, Incorporated
- Stephen L. Seagren
- Laurel Seaholm
All providers in La Jolla, CA · Plastic Surgery Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.