| NPI | 1750263836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARDAD FOROUZANPOUR Owner 424-279-9610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2025-07-22 |
| Last Update Date | 2025-07-22 |