BLUE PACIFIC AESTHETIC MEDICAL GROUP (NPI# 1124074059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124074059 |
| Entity Type | Organization |
| Organization Name | BLUE PACIFIC AESTHETIC MEDICAL GROUP |
| Practice Address |
415 Pier Ave Hermosa Beach CA 90254-3820 |
| Mailing Address |
210 N Tustin Ave Santa Ana CA 92705-3807 |
| Practice Telephone | 3103796074 |
| Mailing Telephone | 8008837243 |
| Mailing Fax Number | 7146471245 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2010-05-04 |
| Authorized Official Name | DR. DOUGLAS ROY MEST (PRESIDENT) |
| Authorized Official Telephone | 7143471010 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
FNP27928 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
415 PIER AVE |
| City | HERMOSA BEACH |
| State | CA |
| Zip Code | 90254-3820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639667710 | Heidi M Carle | Registered Nurse | 415 Pier Ave, Hermosa Beach, CA 90254-3820 | 2018-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316501356 | Brianna Naomi Munoz | Behavioral Analyst | 1601 Ca-1, Suite 175, Hermosa Beach, CA 90254 | 2019-04-25 |
| 1134681430 | Duyen Thi Dinh | Pharmacist | 155 Ca-1, Hermosa Beach, CA 90254 | 2019-04-04 |
| 1407312978 | Evelyn Michelle Escobar | Behavior Technician | 1601 Ca-1, Ste 175, Hermosa Beach, CA 90254 | 2019-02-20 |
| 1124598750 | Maria Inaty | Behavioral Analyst | 2447 Pacific Coast Hwy Suite 111, Hermosa Beach, CA 90254 | 2018-11-27 |
| 1023508538 | Melissa Solis | Acupuncturist | 727 2nd Street, #107, Hermosa Beach, CA 90254 | 2018-05-10 |
| 1700319316 | Anna Raymond | Dentist | 1559 Pacific Coast Hwy Ste 101, Hermosa Beach, CA 90254 | 2017-04-10 |
| 1588916506 | Layla Olive | Speech-Language Pathologist | 2132 Monterey Blvd, Apt B, Hermosa Beach, CA 90254 | 2012-10-15 |
| 1588894307 | Linda E. Brochert-saker | Marriage & Family Therapist | 2200 Pacific Coast Hwy. #208, Hermosa Beach, CA 90254 | 2009-07-15 |
| 1689816050 | Blue Water Endeavors, Inc. | Home Health | 13405 Inglewood Avenue, Suite 6, Hawthorne, CA 90254 | 2009-04-01 |
| 1043408420 | Brandon Hyatt | Marriage & Family Therapist | 263 27th Court, Hermosa Beach, CA 90254 | 2007-10-10 |
| Find all providers in zip 90254 | ||||
| Taxonomy Code | 2082S0099X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| Specialization | Plastic Surgery Within the Head and Neck |
| A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. A subspecialty certificate was approved by the ABMS in 2000. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346860079 | Scanning Trend, Inc | Plastic Surgery | 3111 Los Feliz Blvd Ste 103, Los Angeles, CA 90039-1599 | 2020-04-22 |
| 1811542319 | Napa Solano Plastic Surgery. Inc. | Plastic Surgery | 1175 Trancas Street, Napa, CA 94558 | 2019-08-02 |
| 1548799927 | Affinity Surgery Center, Inc | Plastic Surgery | 16311 Ventura Blvd Ste #555, Encino, CA 91436-4314 | 2017-06-08 |
| 1144774613 | Joseph Lochinvar Dinglasan Sr Md Sr. | Plastic Surgery | 709 Bowcreek Dr, Diamond Bar, CA 91765-1885 | 2016-08-12 |
| 1538523105 | Zormeier Cosmetic Surgery & Longevity Center | Plastic Surgery | 431 East Street Ste B, Healdsburg, CA 95448 | 2016-04-11 |
| 1134588775 | Beverly Hills of Westlake Plastic Surgery, Inc. | Plastic Surgery | 115 Jensen Ct # 200, Thousand Oaks, CA 91360-7406 | 2016-02-10 |
| 1144547183 | Melanie Malone | Plastic Surgery | 4150 Regents Park Row Ste 280, La Jolla, CA 92037-1417 | 2010-04-30 |
| 1407924137 | Robert F. Nemeroff, M.d., Inc. | Plastic Surgery | 1509 Manning Ave, Los Angeles, CA 90024-5813 | 2006-12-01 |
| 1568495562 | Richard A. Gangnes M.d. Inc. | Plastic Surgery | 665 Camino De Los Mares Ste 100, San Clemente, CA 92673-2840 | 2006-07-10 |
| 1366400830 | Vincent C Hung | Plastic Surgery | 452 North Altadena Dr., Pasadena, CA 91107 | 2006-05-03 |
| Find all providers with the same taxonomy | ||||
| City | HERMOSA BEACH |
| Zip Code | 90254 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.