John B. Slayback, M.D., Inc.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

A21757 Issued in CA

Legal business name

JOHN B. SLAYBACK, M.D., INC.

Practice address

355 Terracina Blvd
Redlands, CA 92373-4819

Phone

(909) 793-3760

Fax

(909) 335-8625

NPI assigned

Oct 19, 2007

Organization subpart

Yes

Parent organization

JOHN B. SLAYBACK, M.D., INC.As reported in NPPES

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

Authorized official

Name

Mr. John B. Slayback, M.D.

Title

President

Phone

(909) 793-3760

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

John B Slayback MD Inc

Locations

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1780873356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 TERRACINA BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734819",
            "telephone_number": "909-793-3760",
            "fax_number": "909-335-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 TERRACINA BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734819",
            "telephone_number": "909-793-3760",
            "fax_number": "909-335-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN B. SLAYBACK, M.D., INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHN B. SLAYBACK, M.D., INC.",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "SLAYBACK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-793-3760",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A21757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1245302223",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Redlands, CA
• Providers in Redlands, CA by specialty
• Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.