| NPI | 1134983901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIVA REBECCA GOLSHANI Consultant 310-367-6763 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-02-12 |