| NPI | 1639444714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA PALOMARES Insurance Coordinator 310-827-2653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A116508) |
| 208200000X Plastic Surgery (Licence: CA A94136) | |
| 208200000X Plastic Surgery (Licence: CA G45892) | |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2014-05-05 |