Modern Institute of Plastic Surgery & Antiaging, Inc.

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

MODERN INSTITUTE OF PLASTIC SURGERY & ANTIAGING, INC.

Practice address

9090 Burton Way
Beverly Hills, CA 90211-1661

Phone

(310) 230-5741

NPI assigned

Nov 8, 2011

Organization subpart

No

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

Authorized official

Name

Ryan Stanton

Title

President

Phone

(310) 230-5741

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 05C0001812

Legal name

MODERN INSTITUTE OF PLASTIC SURGERY, INC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 17, 2006

Last certification

Nov 17, 2006

Ownership / control type

Proprietary

Facility address

9090 Burton Way
Beverly Hills, CA 90211

Locations

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320710400000",
    "number": "1619254406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 S BEVERLY DR",
            "address_2": "STE. 353",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9090 BURTON WAY",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111661",
            "telephone_number": "310-230-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN INSTITUTE OF PLASTIC SURGERY & ANTIAGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A",
        "authorized_official_last_name": "STANTON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-230-5741"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mobin Medical Corporation
• Fardad Mobin, M.D.
• Farivar Mobin, D.C.
• Robert Mocharla, M.D.
• Modern Institue of Surgery, Inc
• Modern Intitute of Plastic Surgery & Anti-Aging
• Modern Surgery Centers LLC
• Michael Modica, M.D.
• Brent R.W. Moelleken, M.D.
• Farshad Moftakhar, D.D.S.

• Sleep Disorder Diagnostic Clinic/Center in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Sleep Disorder Diagnostic Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.