Pacific Coast Craniofacial and Pediatric Plastic Surgery Inc.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

PACIFIC COAST CRANIOFACIAL AND PEDIATRIC PLASTIC SURGERY INC.

Practice address

1640 Newport Boulevard
Suite 450
Costa Mesa, CA 92627-7737

Phone

(949) 706-3100

Fax

(949) 706-3265

NPI assigned

May 6, 2013

Last updated

May 6, 2013By 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

Michael James Sundine, M.D.

Title

Presiden

Phone

(949) 706-3100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367798400000",
    "number": "1831534742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 NEWPORT BOULEVARD",
            "address_2": "SUITE 450",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926277737",
            "telephone_number": "949-706-3100",
            "fax_number": "949-706-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 NEWPORT BOULEVARD",
            "address_2": "SUITE 450",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926277737",
            "telephone_number": "949-706-3100",
            "fax_number": "949-706-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COAST CRANIOFACIAL AND PEDIATRIC PLASTIC SURGERY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-06",
        "last_updated": "2013-05-06",
        "status": "A",
        "authorized_official_last_name": "SUNDINE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDEN",
        "authorized_official_telephone_number": "949-706-3100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Costa Mesa, CA
• Providers in Costa Mesa, 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 May 6, 2013; 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.