Form Md Plastic Surgery

LBN: Form Md Plastic Surgery
Form Md Plastic Surgery is an health care organization with primary practice located at 26691 Plaza Ste 200 , Mission Viejo CA 92691-8582. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery, Allopathic & Osteopathic Physicians / Surgery, Ambulatory Health Care Facilities / Medical Specialty. Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery is the primary health care specialty. Form Md Plastic Surgery can be contacted via phone (949) 998-2020, or through Pollei, Taylor R via phone (949) 998-2020.

Contact Information

Primary practice address
26691 Plaza Ste 200 Mission Viejo CA 92691-8582
Phone: (949) 998-2020
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Pollei, Taylor R Doctor of Medicine (MD)
Phone: (949) 998-2020

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X
Allopathic & Osteopathic Physicians / Surgery 208600000X
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X

Profile Details

NPI number 1164053104
LBN Legal business name Form Md Plastic Surgery
DBA Doing business as
Authorized official Pollei, Taylor R Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 29th, 2020
Last updated Apr 26th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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