Wave Medical Group Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

WAVE MEDICAL GROUP INC

Practice address

720 Paularino Ave Ste 200
Costa Mesa, CA 92626-6917

Phone

(213) 383-4800

NPI assigned

Sep 6, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Peter Geon Lee, MD

Title

Owner

Phone

(213) 383-4800

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan David Shifren, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Newport Beach, CA
  • NPI 1144387952
  NPD (past)
• Denise Rae Wong, M.D.

  • Facial Plastic Surgery Physician
  • San Francisco, CA
  • NPI 1215191846
  NPD (past)
• Ben H Lee, MD

  • Specialist
  • Englewood, CO
  • NPI 1447370580
  NPD (past)

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536192000000",
    "number": "1306328265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3680 WILSHIRE BLVD STE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 PAULARINO AVE STE 200",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926266917",
            "telephone_number": "213-383-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-06",
        "last_updated": "2018-09-06",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "GEON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-383-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La'Ah Wash
• Adam M Wass, M.D.
• Cristina M Waterman
• Elizabeth Lee Waterman
• Tracy Lee Watson
• Wayne Wilson Licensed Clinical Social Worker Inc.
• We Care Path
• Cassandra Weatherman
• Weaver Chiropractic Wellness, Inc
• Michelle Yuka Weaver, DC, IBCLC

• Surgery Physician in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.