# FORM MD PLASTIC SURGERY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164053104
- **Authorized official:** TAYLOR R POLLEI MD (CEO/PROVIDER)
- **Authorized official phone:** (949) 998-2020

## Contact information

- **Practice address:** 26691 PLAZA STE 200, MISSION VIEJO, CA 92691-8582
- **Practice address phone:** (949) 998-2020
- **Mailing address:** 26691 PLAZA STE 200, MISSION VIEJO, CA 92691-8582
- **Mailing address phone:** (949) 998-2020
- **Mailing address fax:** (949) 998-2021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | NULL | Yes |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | — | Yes |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/29/2020
- **Last updated:** 04/26/2023