Facial Reconstructive Surgical and Medical Center

Primary specialty

Sleep Medicine (Otolaryngology) PhysicianTaxonomy code 207YS0012X

Legal business name

FACIAL RECONSTRUCTIVE SURGICAL AND MEDICAL CENTER

Practice address

750 Welch Rd.
Suite 317
Palo Alto, CA 94304-1510

Phone

(650) 328-0511

Fax

(650) 328-3419

NPI assigned

Mar 6, 2007

Last updated

Aug 22, 2020By 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

Ms. Carolyn S. Oderio

Title

Office Manager

Phone

(650) 328-0511

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Jerome Eugene Hester, MD

  • Sleep Medicine (Otolaryngology) Physician
  • Palo Alto, CA
  • NPI 1477629483
  NPD (past)
• Robert Wayne Riley, MD

  • Sleep Medicine (Otolaryngology) Physician
  • Palo Alto, CA
  • NPI 1831264068
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306976808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 WELCH RD.",
            "address_2": "SUITE 317",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041510",
            "telephone_number": "650-328-0511",
            "fax_number": "650-328-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WELCH RD.",
            "address_2": "SUITE 317",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041510",
            "telephone_number": "650-328-0511",
            "fax_number": "650-328-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL RECONSTRUCTIVE SURGICAL AND MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ODERIO",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "650-328-0511",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL #",
            "identifier": "4021229",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eyes of the Bay Optometry
• Stephen Chukwuma Ezeji-Okoye, M.D.
• Miriam Ezray, LCSW, MPH
• Sofia Janine Fabbrizio, RD
• Christiana Fachin, MAT, BCBA
• Mark Fadil, CMP
• Amy Fahey, OTR/L
• Michael Fahmy
• Bradley Fahs, RN, MS, CNS
• Jeffrey Clayton Faig, MD

• Otolaryngology Physician in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.