Provider Demographics
NPI:1083955330
Name:BELLEVUE PLASTIC SURGERY CENTER
Entity Type:Organization
Organization Name:BELLEVUE PLASTIC SURGERY CENTER
Other - Org Name:NEWVUE PLASTIC SURGERY PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:GUIHO
Authorized Official - Last Name:MIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-463-9883
Mailing Address - Street 1:10047 MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6019
Mailing Address - Country:US
Mailing Address - Phone:425-463-9883
Mailing Address - Fax:425-968-4631
Practice Address - Street 1:10047 MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6019
Practice Address - Country:US
Practice Address - Phone:425-463-9883
Practice Address - Fax:425-968-4631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical