| NPI | 1063926970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICKA RUHL Office Manager 310-450-7619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2018-03-17 |