Vicki A Maierle, PERMANENT MAKE UP AR

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

9834 Genesee Ave
Suite 128
La Jolla, CA 92037-1223

Phone

(619) 368-6269

Fax

(858) 457-0669

NPI assigned

Oct 12, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Pink Icing on the Cake

  • Special Hospital
  • San Diego, CA
  • NPI 1184150971
  NPD (past) Authorized official

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

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255305600000",
    "number": "1760717532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 NOBEL DR",
            "address_2": "#102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225789",
            "telephone_number": "619-368-6269",
            "fax_number": "858-457-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9834 GENESEE AVE",
            "address_2": "SUITE 128",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371223",
            "telephone_number": "619-368-6269",
            "fax_number": "858-457-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIERLE",
        "first_name": "VICKI",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PERMANENT MAKE UP AR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2009-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahmood Mahdavi, M.D.
• Shelby Maher, PSYD
• Mirha Mahmood, MEDICAL STUDENT
• Annie Mai, PHARMD
• Christina M Maiello
• Neil Maitra
• Michelle M Majd, DDS
• Ahmed Makhlouf, M.D.
• Mahmoud Malas, M.D.
• Joanne Malinak, MD

• Contractor in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Contractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2009; 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.