NPIMap

Organization Active NPI

Reconstructive Services Medical Group, Inc

  • Surgical Oncology Physician
  • Orange, CA
National Provider Identifier
1992851893
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
G25063 Issued in CA
Legal business name
RECONSTRUCTIVE SERVICES MEDICAL GROUP, INC
Practice address
212 E Chapman Ave
Orange, CA 92866-1506
Phone
(714) 633-9761
Fax
(714) 633-0802
NPI assigned
Jan 25, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Glenn R Allison, M.D.NPI 1245386051
Title
President
Phone
(714) 633-9761

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X G25063 CA
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X G25063 CA
Surgical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086X0206X G25063 CA Primary

Addresses

Primary practice location

212 E Chapman Ave
Orange, CA 92866-1506

Mailing address

212 E Chapman Ave
Orange, CA 92866-1506
Phone (714) 633-9761

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1992851893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661506",
            "telephone_number": "714-633-9761",
            "fax_number": "714-633-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661506",
            "telephone_number": "714-633-9761",
            "fax_number": "714-633-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECONSTRUCTIVE SERVICES MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-633-9761",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G25063",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "G25063",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "G25063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.