Provider Demographics
NPI:1538366265
Name:SALINAS VALLEY PLASTIC SURGERY ASSOCIATES, A MEDICAL CORPORATION
Entity type:Organization
Organization Name:SALINAS VALLEY PLASTIC SURGERY ASSOCIATES, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROMANS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:831-758-2746
Mailing Address - Street 1:1260 S MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2292
Mailing Address - Country:US
Mailing Address - Phone:831-758-2746
Mailing Address - Fax:
Practice Address - Street 1:1260 S MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2292
Practice Address - Country:US
Practice Address - Phone:831-758-2746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2086S0122X174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ23896ZMedicare PIN