Dr. Millicent Rovelo

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

A130080 Issued in CA

Legal business name

DR. MILLICENT ROVELO

Practice address

465 N Roxbury Dr Ste 1001
Beverly Hills, CA 90210-4213

Phone

(310) 954-1355

Fax

(310) 248-6256

NPI assigned

Apr 17, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Millicent Overley Rovelo, M.D.

Title

Owner

Phone

(310) 403-0562

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1235663261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 N ROXBURY DR STE 1001",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104213",
            "telephone_number": "310-954-1355",
            "fax_number": "310-248-6256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 N ROXBURY DR STE 1001",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104213",
            "telephone_number": "310-954-1355",
            "fax_number": "310-248-6256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 S Spalding Dr",
            "address_2": "#340",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902121800",
            "country_code": "US",
            "telephone_number": "310-777-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 S Spalding Dr",
            "address_2": "#340",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902121800",
            "country_code": "US",
            "telephone_number": "310-777-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR. MILLICENT ROVELO",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-17",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "ROVELO",
        "authorized_official_first_name": "MILLICENT",
        "authorized_official_middle_name": "OVERLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-403-0562",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A130080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.