FORM MD PLASTIC SURGERY – NPI #1164053104
Otolaryngology
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
FORM MD PLASTIC SURGERY is an otolaryngologist located in MISSION VIEJO, CA. NPPES has assigned the NPI number 1164053104 to FORM MD PLASTIC SURGERY on January 29, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207YX0905X from the Health Care Provider Taxonomy code set, which is classified as Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery
The NPI profile was previously updated about 3 years ago on Apr 26, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FORM MD PLASTIC SURGERY below.
NPI Profile for
FORM MD PLASTIC SURGERY
(more than 6 years ago)
MISSION VIEJO, CA 92691-8582 Phone: (949) 998-2020 Fax:
CEO/PROVIDER
Phone: (949) 998-2020
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 207YX0905X - Otolaryngology / Otolaryngology/Facial Plastic Surgery (Primary) |
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| 261QM2500X - Clinic/Center / Medical Specialty |
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| 208600000X - Surgery |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.