GRANT STEVENS, M.D., INC (NPI# 1639444714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639444714 |
| Entity Type | Organization |
| Organization Name | GRANT STEVENS, M.D., INC |
| Practice Address |
4644 Lincoln Blvd Suite 552 Marina Del Rey CA 90292-6391 |
| Practice Telephone | 3108272653 |
| Practice Fax Number | 3108231984 |
| Mailing Telephone | 3108272653 |
| Mailing Fax Number | 3108231984 |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2014-05-05 |
| Authorized Official Name | JESSICA PALOMARES (INSURANCE COORDINATOR) |
| Authorized Official Telephone | 3108272653 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208200000X | Plastic Surgery | A94136 | CA | Allopathic & Osteopathic Physicians |
| N | 208200000X | Plastic Surgery | G45892 | CA | Allopathic & Osteopathic Physicians |
| N | 208200000X | Plastic Surgery | A116508 | CA | Allopathic & Osteopathic Physicians |
| Y | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
4644 LINCOLN BLVD SUITE 552 |
| City | MARINA DEL REY |
| State | CA |
| Zip Code | 90292-6391 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972503431 | Anthony Joseph Zoppi | Orthopaedic Surgery | 4644 Lincoln Blvd, Ste #101, Marina Del Rey, CA 90292-6621 | 2005-07-27 |
| 1104295278 | Matthew James Cunningham | Physician Assistant | 4644 Lincoln Blvd, Marina Del Rey, CA 90292-6313 | 2015-09-18 |
| 1356778476 | Marina Dermatology Associates | Dermatology | 4644 Lincoln Blvd, Suite 552, Marina Del Rey, CA 90292-6313 | 2013-10-03 |
| 1033483193 | Jonathan D. Rand, M.d. Inc | Internal Medicine | 4644 Lincoln Blvd, 113, Marina Del Rey, CA 90292-6313 | 2012-03-06 |
| 1154692507 | Eleby R. Washington IIi Md PC | Orthopaedic Surgery | 4644 Lincoln Blvd, Suite 101, Marina Del Rey, CA 90292-6313 | 2012-01-17 |
| 1255609004 | Jeremy E. Korman Md, A Professional Corporation | Non-Pharmacy Dispensing Site | 4644 Lincoln Blvd, Suite 450, Marina Del Rey, CA 90292-6313 | 2011-12-08 |
| 1750683090 | Robert P. Waldman, M.d. A Professional Corporation | Internal Medicine | 4644 Lincoln Blvd, Ste 540, Marina Del Rey, CA 90292-6313 | 2010-11-18 |
| 1679886535 | Heleen Robins Md Inc | Family Medicine | 4644 Lincoln Blvd, Suite 408, Marina Del Rey, CA 90292-6313 | 2010-07-21 |
| 1295050714 | Akash Bajaj Md Inc A California Professional Medical Corporation | Pain Medicine | 4644 Lincoln Blvd, Suite 424, Marina Del Rey, CA 90292-6313 | 2010-03-29 |
| 1407095649 | Antoine Roberts M.d., Inc | Orthopaedic Surgery | 4644 Lincoln Blvd, Marina Del Rey, CA 90292-6313 | 2009-02-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972142420 | Katy Kleinberg | Physical Therapist | 4820 Lincoln Blvd., Marina Del Rey, CA 90292 | 2020-01-02 |
| 1568028330 | Kylie Nakamine | Physical Therapist | 4820 Lincoln Bld, Marina Del Rey, CA 90292 | 2019-05-16 |
| 1033627807 | Kareema Nasouf | Social Worker | 578 Washington Blvd. #815, Marina Del Rey, CA 90292 | 2018-01-16 |
| 1861916611 | Jaqueline Berenice Higbee | Behavior Technician | 13428 Maxella Ave Apt 913, Marina Del Rey, CA 90292 | 2017-08-02 |
| 1063942696 | Luis Albert Japngie | Chiropractor | 13816 Bora Bora Way, A-109, Marina Del Rey, CA 90292 | 2017-06-15 |
| 1427509082 | Melissa Dowling | Nurse Anesthetist, Certified Registered | 4750 Lincoln Blvd Apt 477, Marina Del Rey, CA 90292 | 2016-10-19 |
| 1578932950 | Gratto Aquatic Rehab | Clinic/Center | 13160 Mindanao Way Ste. 308, Marina Del Ray, CA 90292 | 2015-09-16 |
| 1285018309 | Reed Chiropractic & Wellness Center A Professional Corporation | Chiropractor | 4207 Del Rey Ave., Marina Del Rey, CA 90292 | 2015-07-18 |
| 1083990725 | James J Kim | Pharmacist | 4009 Lincoln Blvd., Walgreens, Marina Del Rey, CA 90292 | 2011-10-26 |
| 1689957805 | Medbil, LLC | Anesthesiology | 1024 Oxford Ave., Marina Del Rey, CA 90292 | 2011-09-23 |
| Find all providers in zip 90292 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740783026 | Luis H. Macias Md Inc | Plastic Surgery | 13924 Marquesas Way Apt 1524, Marina Del Rey, CA 90292-6018 | 2018-03-13 |
| 1770623761 | Herbert Michael Goldberg | Plastic Surgery | 4403 Ocean Front Walk Apt 204, Marina Del Rey, CA 90292-6733 | 2007-02-07 |
| 1902318553 | Jonathan Kanevsky | Plastic Surgery | 4644 Lincoln Blvd Ste 552, Marina Del Rey, CA 90292-6391 | 2017-11-03 |
| 1114347986 | Justin Perez | Plastic Surgery | 4560 Admiralty Way, Marina Del Rey, CA 90292-5423 | 2014-04-21 |
| 1154564656 | Ziyad Shawkat Hammoudeh | Plastic Surgery | 4644 Lincoln Blvd Ste 552, Marina Del Rey, CA 90292 | 2009-04-14 |
| 1275701419 | Dean Plastic Surgery Associates, Inc. | Plastic Surgery | 4832 Lincoln Blvd, Marina Del Rey, CA 90292-6917 | 2008-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696048 | Victor Liu Md, A Medical Corporation | Plastic Surgery | 1720 El Camino Real Ste 200, Burlingame, CA 94010-3226 | 2020-10-09 |
| 1629683255 | Veritas Aesthetics PC | Plastic Surgery | 23838 Valencia Blvd Ste 260, Valencia, CA 91355-5630 | 2020-09-10 |
| 1700405586 | Keyian Paydar, Md, PC | Plastic Surgery | 3991 Macarthur Blvd Ste 320, Newport Beach, CA 92660-3004 | 2020-04-13 |
| 1548892045 | Adventist Health Physicians Network | Plastic Surgery | 301 Science Dr Ste 180, Moorpark, CA 93021-0800 | 2020-02-12 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1083259840 | Remedy Place Physicians | Plastic Surgery | 8305 Sunset Blvd, Los Angeles, CA 90069 | 2019-11-15 |
| 1851945646 | Skinzone Medical Inc | Plastic Surgery | 3374 S. Bristol St, Santa Ana, CA 92704 | 2019-07-30 |
| 1790341832 | Frederic Jerome Kolb | Plastic Surgery | 200 W Arbor Dr # Mc8890, San Diego, CA 92103-1911 | 2019-05-14 |
| 1588125835 | Beauty Eternal, Inc | Plastic Surgery | 1260 East Ave Ste 130, Chico, CA 95926-1021 | 2019-03-28 |
| 1689131229 | Schoemann Reconstructive Surgery | Plastic Surgery | 477 N El Camino Real Ste D101, Encinitas, CA 92024-1370 | 2019-03-01 |
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| City | MARINA DEL REY |
| Zip Code | 90292 |
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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.