Provider Demographics
NPI:1598770950
Name:DONALD I. ALTMAN MD
Entity Type:Organization
Organization Name:DONALD I. ALTMAN MD
Other - Org Name:IRVINE PLASTIC SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:I
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-727-3999
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE 1011
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3711
Mailing Address - Country:US
Mailing Address - Phone:949-727-3999
Mailing Address - Fax:949-727-9053
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE 1011
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3711
Practice Address - Country:US
Practice Address - Phone:949-727-3999
Practice Address - Fax:949-727-9053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051341Medicare Oscar/Certification