| NPI | 1033966346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLESTON MIRADOR CHUA Owner 858-699-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2026-05-12 |