| NPI | 1093925166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN EVANS Owner 310-550-5893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CA A70983) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |