Innovative Plastic & Cosmetic Surgery Inc

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A90876 Issued in CA

Legal business name

INNOVATIVE PLASTIC & COSMETIC SURGERY INC

Practice address

6610 Flanders Dr
Suite 101
San Diego, CA 92121-3940

Phone

(858) 457-2888

Fax

(888) 347-0124

NPI assigned

Mar 16, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Khang Thai Nguyen, MDNPI 1265590897

Title

President

Phone

(858) 457-2888

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

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

• Khang Thai Nguyen, MD

  • Plastic Surgery Physician
  • Del Mar, CA
  • NPI 1265590897
  Medicare reassignment Care Compare group NPD Authorized official
• Andrew Richard Bauder, MD

  • Surgery of the Hand (Plastic Surgery) Physician
  • San Diego, CA
  • NPI 1720433428

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Yan Tomas Ortiz-Pomales, M.D.

  • Plastic Surgery Physician
  • San Diego, CA
  • NPI 1346448537
  Medicare reassignment NPD
• Eamon B. O'Reilly, MD

  • Plastic and Reconstructive Surgery Physician
  • Columbia, MO
  • NPI 1326097932

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1205625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1528239761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6610 FLANDERS DR",
            "address_2": "SUITE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213940",
            "telephone_number": "858-457-2888",
            "fax_number": "888-347-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6610 FLANDERS DR",
            "address_2": "SUITE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213940",
            "telephone_number": "858-457-2888",
            "fax_number": "888-347-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PLASTIC & COSMETIC SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-16",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KHANG",
        "authorized_official_middle_name": "THAI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-457-2888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A90876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dulce Illiana Innocenzi, MD
• Innova Home Health Inc
• Innova Hospice Inc.
• Innovations Academy
• Innovative Physical Therapy Inc
• Innovative Surgery Center LLC
• Innovative Ultrasound Imaging, Inc.
• Heather Inns
• John Paul Inocentes
• Inocras Inc

• Plastic Surgery Physician in San Diego, CA
• Providers in San Diego, 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 Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.