Organization Active NPI

Los Angeles ENT Facial Plastics Center, Inc

  • Medical Specialty Clinic/Center
  • Redondo Beach, CA
National Provider Identifier
1225463797
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
C52571 Issued in CA
Legal business name
LOS ANGELES ENT FACIAL PLASTICS CENTER, INC
Practice address
520 N Prospect Ave
Suite 302
Redondo Beach, CA 90277-3041
Phone
(310) 798-1515
NPI assigned
Sep 3, 2013
Last updated
Aug 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Authorized official

Name
Dr. Sherif Ammar, MDNPI 1497746598
Title
President
Phone
(201) 725-0138

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X C52571 CA Primary

Addresses

Primary practice location

520 N Prospect Ave
Suite 302
Redondo Beach, CA 90277-3041

Mailing address

12409 Lincolnshire Dr
Bakersfield, CA 93311-9584
Phone (201) 725-0138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140326000860 CA Part B Supplier - Clinic/Group Practice 5890926364 Receives reassigned benefits from 1 practitioner
Practice locations: Culver City, CA; Long Beach, CA; Redondo Beach, CA; Seal Beach, CA

National Provider Directory

National Provider Directory

Locations

16899 Algonquin St
Ste A
Huntington Beach, CA 92649
Phone (714) 840-2447

520 N Prospect Ave
Redondo Beach, CA 90277
Phone (310) 376-8816

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1225463797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12409 LINCOLNSHIRE DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933119584",
            "telephone_number": "201-725-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE",
            "address_2": "SUITE 302",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773041",
            "telephone_number": "310-798-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES ENT FACIAL PLASTICS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-03",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "AMMAR",
        "authorized_official_first_name": "SHERIF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-725-0138",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "C52571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.