RESTORE SD PLASTIC SURGERY (NPI# 1770020471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770020471 |
| Entity Type | Organization |
| Organization Name | RESTORE SD PLASTIC SURGERY |
| Practice Address |
8929 University Center Ln Suite 201 San Diego CA 92122-1006 |
| Mailing Address |
13056 Seagrove St San Diego CA 92130-3203 |
| Practice Telephone | 8584447578 |
| Mailing Telephone | 8584447578 |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-01-20 |
| Authorized Official Name | DR. TRENT D DOUGLAS (PRESIDENT) |
| Authorized Official Telephone | 8584447578 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
A67126 | CA | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
A62940 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
8929 UNIVERSITY CENTER LN SUITE 201 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92122-1006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730167677 | Mona Zohdi Mofid | Dermatology | 8929 University Center Ln, Suite 202, San Diego, CA 92122-1006 | 2005-12-31 |
| 1598200719 | Lindsey Schaefer | Speech-Language Pathologist | 8929 University Center Ln, San Diego, CA 92122-1006 | 2016-12-23 |
| 1710422134 | Susan Neese | Speech-Language Pathologist | 8929 University Center Ln, San Diego, CA 92122-1006 | 2016-12-20 |
| 1215345590 | North County Orthopedic Medical Group Inc | Clinic/Center | 8929 University Center Ln, #100, San Diego, CA 92122-1006 | 2014-07-30 |
| 1629329776 | Jami Kristen Lindner | Physician Assistant | 8929 University Center Ln, Suite 205, San Diego, CA 92122-1006 | 2012-09-28 |
| 1386908267 | Christine Frances Rodolfo | Audiologist | 8929 University Center Ln, #208, San Diego, CA 92122-1006 | 2012-06-26 |
| 1376818690 | Scott W. Barttelbort, M.d., Apc | Plastic Surgery | 8929 University Center Ln, Suite 210, San Diego, CA 92122-1006 | 2012-03-20 |
| 1508139387 | Arnold Robert Yalam | Specialist | 8929 University Center Ln, San Diego, CA 92122-1006 | 2012-02-09 |
| 1508144635 | Boaz Ritblatt | Physical Therapist | 8929 University Center Ln, Suite 200, San Diego, CA 92122-1006 | 2011-07-22 |
| 1033402326 | James R Vevaina Md Professional Corporation | Internal Medicine | 8929 University Center Ln, Suite 100, San Diego, CA 92122-1006 | 2011-05-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912561630 | Neal Yacoo | Pharmacist | 9085 Judicial Drive #2137, San Diego, CA 92122 | 2019-04-29 |
| 1598242828 | Gena Rachel Katzer | Social Worker | 3246 Willard St, San Diego, CA 92122 | 2018-07-19 |
| 1164919791 | Janine Marie Battaglia | Nurse Practitioner | Scripps Health Express, 4350 La Jolla Villlage Drive Ste 130, San Diego, CA 92122 | 2018-04-19 |
| 1669991899 | Lindsay Y Ditmars | Pharmacist | 7545 Charmant Dr. #1322, 1322, San Diego, CA 92122 | 2017-09-19 |
| 1154747103 | Rebecca Jackson | Nurse Practitioner | 3655 Nobel Drive, Suite 660, Peak Health Solutions, San Diego, CA 92122 | 2014-03-14 |
| 1851726582 | Grace Lorelei Allen | Doula | 2728 Nansen Avenue, San Diego, CA 92122 | 2013-09-12 |
| 1427301894 | Barry Katzman, M.d., Inc., Apc | Optometrist | 4413 Lajolla Village Dr., Spc. P1, San Diego, CA 92122 | 2012-10-22 |
| 1912295361 | Yingjian Liang | Psychiatry & Neurology | Gillman Drive 9500, San Diego, CA 92122 | 2011-07-19 |
| 1467775486 | David Michael Trejo | Psychologist | 5080 Shoreham Place, Suite 103, San Diego, CA 92122 | 2010-03-04 |
| 1225369556 | Jeffrey J Abrams | Internal Medicine | 3395 Willard St, San Diego, CA 92122 | 2010-01-27 |
| Find all providers in zip 92122 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598245474 | Jenny Marie Hullinger | Surgery | 711 4th Ave Ste 200, San Diego, CA 92101-6863 | 2018-08-20 |
| 1811430234 | Marc Hamilton Hedrick | Surgery | 3020 Callan Rd, San Diego, CA 92121-1109 | 2016-12-02 |
| 1881947471 | Amir. M. Karam Inc. | Surgery | 4765 Carmel Mountain Rd., Suite 201, San Diego, CA 92130 | 2012-10-19 |
| 1861717647 | Charlie Chen | Surgery | 3399 1st Ave, San Diego, CA 92103-5601 | 2010-04-05 |
| 1932321270 | Deniz J Gocken | Surgery | 11589 Wannacut Pl, San Diego, CA 92131-3733 | 2007-05-03 |
| 1154415891 | Thomas R. Vecchione | Surgery | 3399 First Avenue, San Diego, CA 92103 | 2006-10-03 |
| 1487653523 | Robert B Pollack | Surgery | 4510 Executive Dr., Suite 105, San Diego, CA 92121-3022 | 2005-07-20 |
| 1962982850 | Amanda Mcgee | Surgery | 711 4th Ave Ste 200, San Diego, CA 92101-6863 | 2018-08-20 |
| 1578869772 | Jason R Hess Plastic Surgery Inc | Surgery | 4060 4th Ave, Suite 120, San Diego, CA 92103-2116 | 2011-02-04 |
| 1780998005 | Coastal Medical Group Inc | Surgery | 12264 El Camino Real, Suite 101, San Diego, CA 92130-3058 | 2010-07-28 |
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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.