Skin Cancer and Reconstructive Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SKIN CANCER AND RECONSTRUCTIVE SURGERY CENTER, LLC

Practice address

180 Newport Center Dr
Suite 157
Newport Beach, CA 92660-6972

Phone

(949) 200-1600

Fax

(949) 200-1610

NPI assigned

Apr 24, 2009

Organization subpart

No

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

Authorized official

Name

Simon Joseph Madorsky, M.D.

Title

Owner

Phone

(949) 200-1600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1265676993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 NEWPORT CENTER DR",
            "address_2": "SUITE 157",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606972",
            "telephone_number": "949-200-1600",
            "fax_number": "949-200-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 NEWPORT CENTER DR",
            "address_2": "SUITE 157",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606972",
            "telephone_number": "949-200-1600",
            "fax_number": "949-200-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN CANCER AND RECONSTRUCTIVE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-24",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "MADORSKY",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-200-1600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sjy Transportation
• Stephen J. Skahen, MD
• Skin Cancer RX-Newport, Inc.
• Robert Skversky, M.D.
• Kristen Lynn Slater, LCSW
• Sleep Architects, Inc.
• Katherine Elizabeth Slezewick, AUD

• Ambulatory Surgical Clinic/Center in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.