| NPI | 1962979484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE ROMAGNOLI Manager 310-801-6741 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2019-03-05 |