| NPI | 1770912354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VISHAL KAPOOR Medical Director 310-913-1735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA 104427) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 54113) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 46887) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 20A9059) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA 116163) | |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A115735) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA 78758) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A82791) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA 107087) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA 94269) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA 94061) | |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2014-06-25 |