SIMON MADORSKY M.D A MEDICAL CORPORATION (NPI# 1417108556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417108556 |
| Entity Type | Organization |
| Organization Name | SIMON MADORSKY M.D A MEDICAL CORPORATION |
| Practice Address |
180 Newport Center Dr Suite 158 Newport Beach CA 92660-6972 |
| Mailing Address |
Po Box 15788 Newport Beach CA 92659-5788 |
| Practice Telephone | 9497191800 |
| Practice Fax Number | 9497191810 |
| Mailing Telephone | 9495744638 |
| Mailing Fax Number | 9495744680 |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2012-01-31 |
| Authorized Official Name | MALINDA VANCE (SUPERVISOR BILLING SUPPORT SERVICES) |
| Authorized Official Telephone | 9495744652 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
A50075 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548407455 | Simon Madorsky M.d A Medical Corporation | Otolaryngology | 1140 W La Veta Ave, Suite 515, Orange, CA 92868-4223 | 2009-01-14 |
| Street Address |
180 NEWPORT CENTER DR SUITE 158 |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92660-6972 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447259981 | Simon Joseph Madorsky | Otolaryngology | 180 Newport Center Dr, 158, Newport Beach, CA 92660-6972 | 2005-07-18 |
| 1477929826 | Erin Garibaldi | Counselor | 180 Newport Center Dr, Newport Beach, CA 92660-6972 | 2015-08-19 |
| 1700267234 | Robert Mcharris | Dentist | 180 Newport Center Dr, Ste 210, Newport Beach, CA 92660-6972 | 2015-06-10 |
| 1477953511 | Newport Beach Surgical and Medical Group Inc | Dermatology | 180 Newport Center Dr, Suite 158, Newport Beach, CA 92660-6972 | 2014-08-26 |
| 1265872402 | Gigi Kroll Md, Apc | Clinic/Center | 180 Newport Center Dr, 265, Newport Beach, CA 92660-6972 | 2013-07-02 |
| 1437592169 | Reconstructive Surgery Center of Newport Beach Inc | Clinic/Center | 180 Newport Center Dr, Suite 150, Newport Beach, CA 92660-6972 | 2013-04-11 |
| 1215284385 | Daines Plastic Surgery Inc | Surgery | 180 Newport Center Dr, 158, Newport Beach, CA 92660-7652 | 2012-08-08 |
| 1609141225 | Kathryn Dyer | Dietitian, Registered | 180 Newport Center Dr, Suite 162, Newport Beach, CA 92660-6972 | 2012-03-15 |
| 1255608907 | Gigi Kroll Mcconnaughey | Clinic/Center | 180 Newport Center Dr, 265, Newport Beach, CA 92660-6972 | 2011-11-23 |
| 1457628513 | Amy Vanblaricom, Md Afc | Clinic/Center | 180 Newport Center Dr, 265, Newport Beach, CA 92660-6972 | 2011-11-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275144024 | Lumins Aesthetic and Wellness, Inc | Dermatology | 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 | 2020-08-14 |
| 1205445798 | Felecia A Pedrogo | Marriage & Family Therapist | 5020 Campus Street, Newport Beach, CA 92660 | 2020-07-30 |
| 1649898388 | Polyviou Dental Corportation, Inc. | Clinic/Center | 120 Newport Beach Drive, Suite 27, Newport Beach, CA 92660 | 2020-07-09 |
| 1154974525 | Jan M. Eckermann, Md Inc. | Neurological Surgery | 1617 W Cliff Dr, Ste 203, Newport Beach, CA 92660 | 2019-07-24 |
| 1235792219 | Horizon Dermatology and Laser Institute | Dermatology | 369 San Miguel Dr. Suite 200, Newport Beach, CA 92660 | 2019-04-16 |
| 1902366925 | Yasmine Central Gohar | Marriage & Family Therapist | 20271 Sw Birch St Ste 200, Newport Beach, CA 92660 | 2019-03-25 |
| 1245703255 | Charison Counseling | Counselor | 4000 Macarthur Bvd Suite 600 East Tower, Newport Beach, CA 92660 | 2019-01-03 |
| 1134698996 | Amber Werner | Chiropractor | 4029 Westerly Place, Suite #115, Newport Beach, CA 92660 | 2018-11-21 |
| 1861969008 | Healthy Me Oc | Dietitian, Registered | 4569 Macarthur Court, Suite 1100, Newport Beach, CA 92660 | 2018-10-25 |
| 1174015192 | Edwin Enwia | Clinic/Center | 1000 Bristol St N Ste 1b, Newport Beach, CA 92660 | 2018-06-05 |
| Find all providers in zip 92660 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174943377 | Sunny Park Md, Inc | Otolaryngology | 901 Dover Dr Ste 126, Newport Beach, CA 92660-5546 | 2014-04-26 |
| 1275955668 | David R Reinstadler M.d. Inc | Otolaryngology | 520 Superior Ave, Suite 240, Newport Beach, CA 92663-3637 | 2014-01-20 |
| 1194150813 | Miller Cosmetics Inc. A Medical Corporation | Otolaryngology | 1501 Superior Ave, Suite 301, Newport Beach, CA 92663-3600 | 2013-09-12 |
| 1053490003 | Kevin Sohi Sadati | Otolaryngology | 400 Newport Center Drive, Suite 100, Newport Beach, CA 92660 | 2006-11-02 |
| 1467534644 | Rami K Batniji | Otolaryngology | 361 Hospital Rd, Suite #329, Newport Beach, CA 92663-3522 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114550498 | Hootan Zandifar Md Inc | Otolaryngology | 8920 Wilshire Blvd Ste 604, Beverly Hills, CA 90211-2006 | 2020-02-14 |
| 1548751183 | Farhad Ardesh Md Inc | Otolaryngology | 11620 Wilshire Blvd Ste 280, Los Angeles, CA 90025-1263 | 2018-05-18 |
| 1154743987 | Keith Jay Wahl | Otolaryngology | 8735 Nottingham Pl, La Jolla, CA 92037-2129 | 2014-01-14 |
| 1295179570 | Ari Joseph Hyman | Otolaryngology | 16311 Ventura Blvd Ste 600, Encino, CA 91436-2134 | 2013-04-17 |
| 1710229893 | Zachary Calnan Fridirici | Otolaryngology | 2233 Post St Fl 3, San Francisco, CA 94115 | 2013-03-26 |
| 1376883975 | Su Mai | Otolaryngology | 13071 Brookhurst St Ste 150, Garden Grove, CA 92843-1024 | 2013-02-20 |
| 1710244892 | Meaghan Noud | Otolaryngology | 421 Post St Fl 14, San Francisco, CA 94102 | 2012-04-13 |
| 1508164500 | Dr. Sasha Maher D.o. | Otolaryngology | 10861 Cherry St Ste 106, Los Alamitos, CA 90720-5403 | 2011-03-01 |
| 1871804187 | Edwin E Breitenbach | Otolaryngology | 2601 Augusta, Tustin, CA 92782-1201 | 2010-07-01 |
| 1467780270 | Robert O Ruder M D A Professional Corporation | Otolaryngology | 8816 Burton Way Fl 1, Beverly Hills, CA 90211-1715 | 2009-12-07 |
| Find all providers with the same taxonomy | ||||
| City | NEWPORT BEACH |
| Zip Code | 92660 |
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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.