| NPI | 1548532872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD GEORGE PRUTSOK President 714-997-7078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA G18825) |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2012-05-31 |