| NPI | 1497249817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER VILLICANA Sole Owner 626-447-6641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A21627) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2018-06-19 |