Organization Active NPI

Cosmetic & Reconstructive Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Lafayette, CA
National Provider Identifier
1912291394
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
COSMETIC & RECONSTRUCTIVE SURGERY CENTER
Practice address
911 Moraga Rd
Suite 205
Lafayette, CA 94549-4579
Phone
(925) 283-8811
Fax
(925) 283-8812
NPI assigned
Jun 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Authorized official

Name
Barbara L Persons, M.D.NPI 1467484246
Title
President
Phone
(925) 283-8811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

911 Moraga Rd
Suite 205
Lafayette, CA 94549-4579

Mailing address

911 Moraga Rd
Suite 205
Lafayette, CA 94549-4579
Phone (925) 283-8811

National Provider Directory

National Provider Directory
Tax ID family
Cosmetic Reconstructive Surgery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

911 Moraga Rd
Ste 205
Lafayette, CA 94549
Phone (925) 283-4012

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307059200000",
    "number": "1912291394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 MORAGA RD",
            "address_2": "SUITE 205",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945494579",
            "telephone_number": "925-283-8811",
            "fax_number": "925-283-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 MORAGA RD",
            "address_2": "SUITE 205",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945494579",
            "telephone_number": "925-283-8811",
            "fax_number": "925-283-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSMETIC & RECONSTRUCTIVE SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-03",
        "last_updated": "2011-06-03",
        "status": "A",
        "authorized_official_last_name": "PERSONS",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-283-8811",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; 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.