Cedar Medical Specialties, PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

FX00057086 Issued in WA

Legal business name

CEDAR MEDICAL SPECIALTIES, PLLC

Doing business as

Cedar Laser and Surgery Center

Practice address

2202 S Cedar St
Ste 150
Tacoma, WA 98405-2318

Phone

(253) 830-5432

Fax

(253) 830-5433

NPI assigned

May 8, 2006

Last updated

Sep 8, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robyn Wallace

Title

Clinical Director

Phone

(253) 830-5432

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cedar Laser and Surgery Center Doing business as

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1194774265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 S CEDAR ST",
            "address_2": "STE 150",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052318",
            "telephone_number": "253-830-5432",
            "fax_number": "253-830-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 S CEDAR ST",
            "address_2": "STE 150",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052318",
            "telephone_number": "253-830-5432",
            "fax_number": "253-830-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR MEDICAL SPECIALTIES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "253-830-5432"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "FX00057086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7109994",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Laser and Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jesus Daniel Cazares
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• Cedar & Sea Psychology Services, PLLC
• Cedar Medical Specialties
• Cedar Medical Specialties, PLLC
• Cedar Medical Specialties, PLLC (Allenmore Optical)
• Cedar Medical Specialties, PLLC (Aesthetic Surgery Centre)
• Osha Grace Cedarcroft, L.M.P.
• James B. Cefalu, M.D.

• Ambulatory Surgical Clinic/Center in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Ambulatory Surgical Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.