Organization · NPI-2

A Beau Jeu Plastic Surgery INC.

Surgery, Plastic and Reconstructive Surgery · San Mateo, CA

NPI number1316136997
StatusActive
Last updated in NPPESOct 18, 2007

Details

NPI
1316136997
Entity type
Organization (NPI-2)
Legal business name
A Beau Jeu Plastic Surgery INC.
Organization subpart
No
Enumeration date
Oct 18, 2007
Last updated
Oct 18, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2086S0122X Surgery, Plastic and Reconstructive SurgeryG626770CAYes

Practice location

212 N San Mateo Dr
San Mateo, CA 94401-2609

Phone 650-342-1511

Mailing address

212 N San Mateo Dr
San Mateo, CA 94401-2609

Phone 650-342-1511

Authorized official

James L Pertsch
President
6503421511

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