Organization Active NPI

Plastic and Reconstructive Care, LLC

  • Plastic and Reconstructive Surgery Physician
  • Beverly Hills, CA
National Provider Identifier
1962979484
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
PLASTIC AND RECONSTRUCTIVE CARE, LLC
Practice address
9735 Wilshire Blvd PH
Beverly Hills, CA 90212-2104
Phone
(310) 860-8915
NPI assigned
Nov 2, 2018
Organization subpart
Yes
Parent organization
LEIF L. ROGERS, MD,LLC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Authorized official

Name
Mr. Mike Romagnoli
Title
Manager
Phone
(310) 801-6741

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X Primary
Ambulatory Surgical Clinic/Center 261QA1903X

Addresses

Primary practice location

9735 Wilshire Blvd PH
Beverly Hills, CA 90212-2104

Mailing address

3505 Alma Ave
Manhattan Beach, CA 90266-3330
Phone (310) 801-6741

National Provider Directory

National Provider Directory
Part of
Leif L Rogers Mdllc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551744000000",
    "number": "1962979484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 ALMA AVE",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663330",
            "telephone_number": "310-801-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9735 WILSHIRE BLVD PH",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122104",
            "telephone_number": "310-860-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC AND RECONSTRUCTIVE CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEIF L. ROGERS, MD,LLC.",
        "enumeration_date": "2018-11-02",
        "last_updated": "2019-03-05",
        "status": "A",
        "authorized_official_last_name": "ROMAGNOLI",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-801-6741",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.