Laguna Aesthetics & Family Wellness Center, Inc

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

LAGUNA AESTHETICS & FAMILY WELLNESS CENTER, INC

Practice address

1100 S Coast Hwy
Suite 212
Laguna Beach, CA 92651-2968

Phone

(949) 632-8087

Fax

(949) 715-5889

NPI assigned

Aug 20, 2015

Organization subpart

No

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

Authorized official

Name

Amanda Miyawaki

Title

Office Manager

Phone

(949) 632-8087

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Simone Kayla Parmenter, FNP

  • Family Nurse Practitioner
  • Laguna Beach, CA
  • NPI 1457993156
  NPD (past)
• Kathryn A Ross, M.D.

  • Gastroenterology Physician
  • Newport Beach, CA
  • NPI 1871537035
  NPD (past)

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1881060135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S COAST HWY",
            "address_2": "SUITE 212",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512968",
            "telephone_number": "949-632-8087",
            "fax_number": "949-715-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S COAST HWY",
            "address_2": "SUITE 212",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512968",
            "telephone_number": "949-632-8087",
            "fax_number": "949-715-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGUNA AESTHETICS & FAMILY WELLNESS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "MIYAWAKI",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "949-632-8087"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Negri Klebanoff, LAC, DIPL OM
• Timothy Earl Korber, M.D.
• Christopher M Kovacs
• Gabor L Kovacs, M.D.
• Kaitlyn Kuo, PSYD
• Laguna Beach Community Clinic, Inc. (Laguna Beach Community Clinic)
• Laguna Beach Dental Excellence
• Laguna Beach Recovery
• Laguna Beach Recovery LLC (Laguna Beach Recovery)
• Laguna Beach Recovery LLC

• Adult Medicine Physician in Laguna Beach, CA
• Providers in Laguna Beach, CA by specialty
• Adult Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.