NPIMap

Organization Active NPI

Santa Monica Surgery & Laser Center Medical Associates, LLC

  • Dermatology Physician
  • Santa Monica, CA
National Provider Identifier
1689954539
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A41084 Issued in CA
Legal business name
SANTA MONICA SURGERY & LASER CENTER MEDICAL ASSOCIATES, LLC
Practice address
2001 Santa Monica Blvd.
Suite 1288W
Santa Monica, CA 90404
Phone
(310) 829-2005
Fax
(310) 453-9201
NPI assigned
Aug 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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

Authorized official

Name
Dr. Robert Patrick Abergel, M.D.
Title
Medical Director
Phone
(310) 829-2005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X A41084 CA Primary

Addresses

Primary practice location

2001 Santa Monica Blvd.
Suite 1288W
Santa Monica, CA 90404

Mailing address

2001 Santa Monica Blvd.
Suite #1288W
Santa Monica, CA 90404
Phone (310) 829-2005

National Provider Directory

National Provider Directory

Locations

2001 Santa Monica Blvd
Ste 1288W
Santa Monica, CA 90404
Phone (310) 829-2005

NPI Registry JSON

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1689954539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD.",
            "address_2": "SUITE #1288W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-829-2005",
            "fax_number": "310-453-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD.",
            "address_2": "SUITE 1288W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-829-2005",
            "fax_number": "310-453-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA MONICA SURGERY & LASER CENTER MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "ABERGEL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-829-2005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A41084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.