Ryan Spivak Integrative Plastic Surgery Inc

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

A113632 Issued in CA

Legal business name

RYAN SPIVAK INTEGRATIVE PLASTIC SURGERY INC

Practice address

2200 W 3Rd St
Suite 120a
Los Angeles, CA 90057-1932

Phone

(310) 739-3197

NPI assigned

Feb 16, 2016

Organization subpart

No

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

Authorized official

Name

Ryan M Spivak, M.D

Title

Authorized Official

Phone

(310) 905-3331

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493942400000",
    "number": "1841659042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 46666",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900460666",
            "telephone_number": "310-739-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W 3RD ST",
            "address_2": "SUITE 120A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571932",
            "telephone_number": "310-739-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN SPIVAK INTEGRATIVE PLASTIC SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2017-05-05",
        "status": "A",
        "authorized_official_last_name": "SPIVAK",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "310-905-3331",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A113632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, 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 5, 2017; 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.