| NPI | 1477269785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE MARIE FURLONG Billing Representative 626-331-6170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2023-01-30 |