| NPI | 1205061090 |
|---|---|
| Former Legal Business Name | RECONSTRUCTIVE SURGERY SPECIALISTS OF SOUTHERN CALIFORNIA |
| Entity Type | Organization |
| Authorized Contact | MICHAEL OMIDI Owner 310-273-8849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA a84519) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2009-05-21 |