Kohli Plastic Surgery Medical Group Inc

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

C51411 Issued in CA

Legal business name

KOHLI PLASTIC SURGERY MEDICAL GROUP INC

Practice address

11100 Warner Ave
Suite 206
Fountain Valley, CA 92708-7506

Phone

(949) 954-8382

Fax

(949) 272-0430

NPI assigned

Jun 9, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Gurmander S. Kohli, MD

Title

Ceo/President

Phone

(949) 954-8382

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327190400000",
    "number": "1629398938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PHOTINIA",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926202218",
            "telephone_number": "949-954-8382",
            "fax_number": "949-272-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 206",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "949-954-8382",
            "fax_number": "949-272-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOHLI PLASTIC SURGERY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-09",
        "last_updated": "2012-01-22",
        "status": "A",
        "authorized_official_last_name": "KOHLI",
        "authorized_official_first_name": "GURMANDER",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "949-954-8382",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "C51411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Robert Kobus, D.C.
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• Jacob Koopman, DO
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• Rebecca Brianna Koppel, DPT

• Plastic Surgery Physician in Fountain Valley, CA
• Providers in Fountain Valley, 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 Jan 22, 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.