| NPI | 1023433836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN BRENNER President 310-777-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A79032) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A79032) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2015-01-06 |