Active NPI
Carlos J. Hermosillo, M.D.
- Plastic Surgery Physician
- Laguna Beach, CA
National Provider Identifier
1447554928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- G22820
- Practice address
- 453 Radcliffe CT
Laguna Beach, CA 92651-3635 - Phone
- (949) 494-2849
- NPI assigned
- Dec 27, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | G22820 | CA | Primary |
Addresses
Primary practice location
453 Radcliffe CT
Laguna Beach, CA 92651-3635
Mailing address
453 Radcliffe CT
Laguna Beach, CA 92651-3635
Phone (949) 494-2849
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G22820 | CA | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293408000000",
"number": "1447554928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "453 RADCLIFFE CT",
"city": "LAGUNA BEACH",
"state": "CA",
"postal_code": "926513635",
"telephone_number": "949-494-2849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "453 RADCLIFFE CT",
"city": "LAGUNA BEACH",
"state": "CA",
"postal_code": "926513635",
"telephone_number": "949-494-2849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMOSILLO",
"first_name": "CARLOS",
"middle_name": "J.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-12-27",
"last_updated": "2010-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "CA",
"license": "G22820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laguna Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.