Bedford Reconstructive Surgery PC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

BEDFORD RECONSTRUCTIVE SURGERY PC

Practice address

417 Via Anita
Redondo Beach, CA 90277-6623

Phone

(516) 439-5160

Fax

(516) 439-5161

NPI assigned

Oct 11, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Tze Yung Ip, MD

Title

Medical Doctor

Phone

(516) 439-5160

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1346715877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2631 MERRICK RD STE 200",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105784",
            "telephone_number": "516-439-5160",
            "fax_number": "516-439-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 VIA ANITA",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902776623",
            "telephone_number": "516-439-5160",
            "fax_number": "516-439-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEDFORD RECONSTRUCTIVE SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "IP",
        "authorized_official_first_name": "TZE",
        "authorized_official_middle_name": "YUNG",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "516-439-5160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE BOARD OF CALIFORNIA",
            "identifier": "A063154",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.