La Vita Real Estate LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LA VITA REAL ESTATE LLC

Doing business as

'B' Street Plastic Surgery

Practice address

1001 B Ave Ste 108
Coronado, CA 92118-3423

Phone

(619) 490-5141

NPI assigned

Apr 12, 2021

Last updated

Apr 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Moneer Jaibaji, MDNPI 1366471096

Title

Medical Director

Phone

(619) 490-5141

Specialties & licenses 1

Addresses

Other names 1

• 'B' STREET PLASTIC SURGERY Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Moneer Jaibaji, M.D.

  • Plastic Surgery Physician
  • La Mesa, CA
  • NPI 1366471096
  NPD Authorized official

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1740860014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 B AVE STE 108",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921183423",
            "telephone_number": "619-490-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 B AVE STE 108",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921183423",
            "telephone_number": "619-490-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA VITA REAL ESTATE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "JAIBAJI",
        "authorized_official_first_name": "MONEER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "619-490-5141",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "'B' STREET PLASTIC SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Knebel, RN
• Arash Kohan, PHARMD
• John Elwood Kohler, OD
• Wael Kouli, MD
• Taylor Kugel
• Taylor Lanier, RN
• Kathryn Laroe, LCSW
• Laura Norton Petrovich MD PC
• Lisa Marems Lazar, PHD
• Angie Lee, PHARM.D.

• Ambulatory Surgical Clinic/Center in Coronado, CA
• Providers in Coronado, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.