Medical Aesthetic Center LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

058102 Issued in GA

Legal business name

MEDICAL AESTHETIC CENTER LLC

Practice address

60 Cinema Lane
Suite 140
Saint Simons Island, GA 31522-6631

Phone

(912) 638-7799

Fax

(912) 638-7755

NPI assigned

Apr 27, 2011

Organization subpart

Yes

Parent organization

MEDICAL AESTETIC & WELLNESS CENTERAs reported in NPPES

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

Authorized official

Name

Dr. Michael Cal Pinell, M.D.

Title

President

Phone

(912) 638-7799

Specialties & licenses 2

Addresses

Part of

Medical Aesthetic Center LLC

Locations

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305244800000",
    "number": "1447541230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 CINEMA LANE",
            "address_2": "SUITE 140",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315226631",
            "telephone_number": "912-638-7799",
            "fax_number": "912-638-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 CINEMA LANE",
            "address_2": "SUITE 140",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315226631",
            "telephone_number": "912-638-7799",
            "fax_number": "912-638-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL AESTHETIC CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL AESTETIC & WELLNESS CENTER",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-05-13",
        "status": "A",
        "authorized_official_last_name": "PINELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-638-7799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "058102",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "058102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Saint Simons Island, GA
• Providers in Saint Simons Island, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; 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.