J S Vincent Medical Group LLC
Plastic Surgery, Plastic Surgery Within the Head and Neck in Los Angeles, CA. Organization (NPI-2).
NPI number1164021598
StatusActive
Last updated in NPPESOct 18, 2020
Details
- NPI
- 1164021598
- Entity type
- Organization (NPI-2)
- Legal business name
- J S Vincent Medical Group LLC
- Organization subpart
- No
- Enumeration date
- Oct 17, 2020
- Certification date
- Oct 18, 2020
- Last updated
- Oct 18, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2082S0099X | Plastic Surgery, Plastic Surgery Within the Head and Neck | – | – | Yes |
Practice location
3111 Los Feliz Blvd Ste 103Los Angeles, CA 90039-1599
Phone 770-895-8483
Mailing address
3111 Los Feliz Blvd Ste 103Los Angeles, CA 90039-1599
Phone 770-895-8483
Authorized official
John Butora
Billing Manager
5627870225
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