Tri Valley Plastic Surgeryprofessional Medical Corpor

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

TRI VALLEY PLASTIC SURGERYPROFESSIONAL MEDICAL CORPOR

Practice address

11820 Dublin Blvd
Dublin, CA 94568-2830

Phone

(925) 875-0700

Fax

(925) 875-0576

NPI assigned

Apr 9, 2010

Last updated

Feb 8, 2018By 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

Beau Ascarrunz

Title

Practice Administrator

Phone

(925) 875-0700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

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.

• Jane Namkung, MD

  • Plastic and Reconstructive Surgery Physician
  • Vancouver, WA
  • NPI 1124218722

  CA

  Medicare reassignment NPD
• Kristen Shui-Chun Yee, MD

  • Plastic Surgery Physician
  • Phoenix, AZ
  • NPI 1346225992

  CA, Plastic and Reconstructive Surgery

  Medicare reassignment NPD
• Steven Williams, MD

  • Plastic Surgery Physician
  • Stockton, CA
  • NPI 1194898023
  Medicare reassignment
• Philip Joseph Wasicek, MD

  • Student in an Organized Health Care Education/Training Program
  • Pittsburgh, PA
  • NPI 1417390790
  NPD (past)

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1851617278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11820 DUBLIN BLVD",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682830",
            "telephone_number": "925-875-0700",
            "fax_number": "925-875-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11820 DUBLIN BLVD",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682830",
            "telephone_number": "925-875-0700",
            "fax_number": "925-875-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI VALLEY PLASTIC SURGERYPROFESSIONAL MEDICAL CORPOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-09",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "ASCARRUNZ",
        "authorized_official_first_name": "BEAU",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "925-875-0700"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renelle Traylor
• Kelly Tremmel-Howell, AU.D.
• Jacci Trevisano
• Tri Valley Dental Care, Inc (Stoneridge Dental Care, Inc)
• Tri Valley Plastic Surgeryprofessional Medical Corpor
• Tri Valley Surgery Center
• Tri-Valley Allergy
• Shwetha Trikutam
• Kevin Trinh, M.D.
• Marian Lynn Tripp

• Plastic and Reconstructive Surgery Physician in Dublin, CA
• Providers in Dublin, 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 Feb 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.