| NPI | 1306549688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL LEON VILLANUEVA CEO 310-248-6250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2023-03-24 |