Individual provider Active NPI

Burr Vonmaur, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Corona del Mar, CA
National Provider Identifier
1619094893
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
C037704 Issued in CA
Practice address
1101 Bayside Drive
Suite 100
Corona del Mar, CA 92625
Phone
(949) 718-6900
Fax
(949) 718-9367
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X C037704 CA
Plastic and Reconstructive Surgery Physician 2086S0122X C037704 CA Primary

Addresses

Primary practice location

1101 Bayside Drive
Suite 100
Corona del Mar, CA 92625

Mailing address

1101 Bayside Drive
Suite 100
Corona del Mar, CA 92625
Phone (949) 718-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050726000646 CA Practitioner - Plastic and Reconstructive Surgery 7911934427 Practice locations: Corona del Mar, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37704CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Viejo Emergency Medical Associates Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1619094893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 BAYSIDE DRIVE",
            "address_2": "SUITE 100",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "92625",
            "telephone_number": "949-718-6900",
            "fax_number": "949-718-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 BAYSIDE DRIVE",
            "address_2": "SUITE 100",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "92625",
            "telephone_number": "949-718-6900",
            "fax_number": "949-718-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONMAUR",
        "first_name": "BURR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "C037704",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "C037704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona del Mar, CA

Sources for this page

Verify at the official NPI Registry.