| NPI | 1013647627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY A BERTRAND Owner/Provider 310-739-8309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2022-06-15 |