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FORM MD PLASTIC SURGERY
NPI 1164053104
Otolaryngology - Otolaryngology/Facial Plastic Surgery in Mission Viejo, CA

Active since January 29, 2020
26691 PLAZA STE 200, MISSION VIEJO, CA 92691(949) 998-2020 Get Directions Write a Review

NPPES record last updated: April 26, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Form Md Plastic Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORM MD PLASTIC SURGERY (NPI 1164053104) is a healthcare organization registered as an otolaryngology/facial plastic surgery in Mission Viejo, California and active in the NPI registry since January 2020. The organization lists Taylor R Pollei, Ceo/provider, as its authorized official.

NPPES Registry Identity

NPI1164053104
Entity TypeOrganization
Primary Taxonomy207YX0905X
Legal Business NameFORM MD PLASTIC SURGERY
Location Address26691 PLAZA STE 200Mission Viejo, CA 92691-8582
Mailing Address26691 Plaza Ste 200Mission Viejo, CA 92691-8582 · (949) 998-2020 · Fax (949) 998-2021
Phone(949) 998-2020
Organization SubpartNo
Authorized OfficialTaylor R PolleiCeo/provider · (949) 998-2020
Enumeration DateJanuary 29, 2020
Last NPPES UpdateApril 26, 2023
NPPES CertifiedApril 26, 2023
✔ NPI 1164053104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOtolaryngology · Otolaryngology/Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YX0905X
Definition
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
Also ListedSurgeryTaxonomy 208600000X
Also ListedClinic/Center · Medical SpecialtyTaxonomy 261QM2500X
26691 PLAZA STE 200, Mission Viejo, CA 92691
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTH ORANGE COUNTY HEMATOLOGY ONCOLOGY ASSOCIATES INC
Internal Medicine (Hematology & Oncology)
26691 PLAZA STE 200
MISSION VIEJO, CA 92691
Orange County (949) 347-0600
DR. TAYLOR R POLLEI M.D.
Otolaryngology (Facial Plastic Surgery)
26691 PLAZA STE 200
MISSION VIEJO, CA 92691
Orange County (949) 998-2020
SOCHOA EQUIPMENT LLC
Internal Medicine (Hematology & Oncology)
26691 PLAZA STE 200
MISSION VIEJO, CA 92691
Orange County (949) 347-0600
MING C. LI MD INC.
Internal Medicine (Hematology & Oncology)
26691 PLAZA STE 200
MISSION VIEJO, CA 92691
Orange County (949) 347-0600
FORM MD 360
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
26691 PLAZA STE 200
MISSION VIEJO, CA 92691
Orange County (949) 438-3644
MING CHARLES LI MD
Internal Medicine (Hematology & Oncology)
26691 PLAZA STE 200
MISSION VIEJO, CA 92691
Orange County (949) 347-0600
TAMI BETH KENNEDY NP
Nurse Practitioner (Women's Health)
26691 PLAZA STE 200
MISSION VIEJO, CA 92691
Orange County (949) 998-2299

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Form MD Plastic Surgery's NPI number?

The NPI number for Form MD Plastic Surgery is 1164053104. It was assigned to this organization in the NPPES registry on January 29, 2020.

Where is Form MD Plastic Surgery located?

Form MD Plastic Surgery is located at 26691 Plaza Ste 200, Mission Viejo, CA 92691. The listed phone number is (949) 998-2020.

What is Form MD Plastic Surgery's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery, with taxonomy code 207YX0905X.

When was this NPI record last updated?

The NPPES record for Form MD Plastic Surgery was last updated on April 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.