NPIMap

Organization Active NPI

Leonard G. Prutsok M.D. Inc.

  • Plastic Surgery Physician
  • Orange, CA
National Provider Identifier
1548532872
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G18825 Issued in CA
Legal business name
LEONARD G. PRUTSOK M.D. INC.
Practice address
1310 W. Stewart Drive
Suite 214
Orange, CA 92868-3837
Phone
(714) 997-9078
Fax
(714) 997-9771
NPI assigned
Feb 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Authorized official

Name
Leonard George Prutsok, M.D.
Title
President
Phone
(714) 997-7078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X G18825 CA Primary

Addresses

Primary practice location

1310 W. Stewart Drive
Suite 214
Orange, CA 92868-3837

Mailing address

1310 W. Stewart Drive
Suite 214
Orange, CA 92868-3837
Phone (714) 997-9078

National Provider Directory

National Provider Directory

Locations

1310 W Stewart Dr
Ste 214
Orange, CA 92868
Phone (714) 997-9078

NPI Registry JSON

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338422400000",
    "number": "1548532872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W. STEWART DRIVE",
            "address_2": "SUITE 214",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683837",
            "telephone_number": "714-997-9078",
            "fax_number": "714-997-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W. STEWART DRIVE",
            "address_2": "SUITE 214",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683837",
            "telephone_number": "714-997-9078",
            "fax_number": "714-997-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEONARD G. PRUTSOK M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2012-05-31",
        "status": "A",
        "authorized_official_last_name": "PRUTSOK",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-997-7078",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G18825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; 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.