| NPI | 1629127196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MATTHEW GALLEGO President 714-935-0073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A84081) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |