FORM MD PLASTIC SURGERY

Otolaryngology/Facial Plastic Surgery Physician

NPI: 1164053104Organization

Specialties, Licenses & Credentials

Surgery Physician

Surgery

Code: 208600000X

Medical Specialty Clinic/Center

Clinic/Center — Medical Specialty

Code: 261QM2500X

Otolaryngology/Facial Plastic Surgery PhysicianPrimary

Otolaryngology — Otolaryngology/Facial Plastic Surgery

Code: 207YX0905X

Contact & Hours

Address: 26691 PLAZA STE 200
MISSION VIEJO, CA 92691
Phone: (949) 998-2020

Quick Facts

NPI: 1164053104
Entity Type: Organization
Medicare: Not confirmed
Specialties: 3
Locations: 1

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