Organization
PLASTIC & RECONSTRUCTIVE SURGERY ASSOCIATES MED GRP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT DONALD LEPORE MD (PRESIDENT)
(408) 356-4241
Entity
Organization
Contact information
Practice address
2581 SAMARITAN DR, SUITE 102, SAN JOSE, CA 95124-4113
(408) 356-4241
(402) 356-4924
Mailing address
2581 SAMARITAN DR STE 102, SAN JOSE, CA 95124-4112
(408) 356-4241
(408) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
00G485880
CA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
00G591810
CA
2086S0122X
Plastic and Reconstructive Surgery Physician
A27409
CA
2086S0122X
Plastic and Reconstructive Surgery Physician
E27409
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356389241
DR LEPORE INDIVUAL NPI NUMBER
CA
01
—
ZZZ15681Z
BCBS
CA
Enumeration date
03/21/2007
Last updated
10/28/2014
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