Organization Active NPI

Associates for Plastic Surgery Medical Group, Inc.

  • Plastic Surgery Physician
  • La Jolla, CA
National Provider Identifier
1639225188
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G21358 Issued in CA
Legal business name
ASSOCIATES FOR PLASTIC SURGERY MEDICAL GROUP, INC.
Practice address
9850 Genesee Ave
Suite 300
La Jolla, CA 92037-1224
Phone
(858) 587-9850
Fax
(858) 622-2066
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Wendell M Smoot III, M.D.
Title
President
Phone
(858) 587-9850

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208200000X G21358 CA Primary
Plastic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208200000X G62141 CA

Addresses

Primary practice location

9850 Genesee Ave
Suite 300
La Jolla, CA 92037-1224

Mailing address

9850 Genesee Ave
Suite 300
La Jolla, CA 92037-1224
Phone (858) 587-9850

National Provider Directory

National Provider Directory

Locations

9850 Genesee Ave
Ste 380
La Jolla, CA 92037
Phone (760) 941-2000

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639225188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE",
            "address_2": "SUITE 300",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371224",
            "telephone_number": "858-587-9850",
            "fax_number": "858-622-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE",
            "address_2": "SUITE 300",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371224",
            "telephone_number": "858-587-9850",
            "fax_number": "858-622-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES FOR PLASTIC SURGERY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMOOT",
        "authorized_official_first_name": "WENDELL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-587-9850",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G21358",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G62141",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.