Provider Demographics
NPI:1215284385
Name:DAINES PLASTIC SURGERY INC
Entity type:Organization
Organization Name:DAINES PLASTIC SURGERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAINES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-719-1800
Mailing Address - Street 1:PO BOX 15847
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-5847
Mailing Address - Country:US
Mailing Address - Phone:949-574-4638
Mailing Address - Fax:949-574-4680
Practice Address - Street 1:180 NEWPORT CENTER DR
Practice Address - Street 2:158
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7652
Practice Address - Country:US
Practice Address - Phone:949-719-1800
Practice Address - Fax:949-719-1810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1202442086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty