| NPI | 1578789046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MARTINEZ Office Manager 562-595-9493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA G39324) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA G39324) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CA G39324) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CA G39324) | |
| 208600000X Surgery (Licence: CA G39324) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: CA G39324) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: CA G39324) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: CA G39324) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2010-09-24 |