Eternal Youth Medical Spa
Surgery, Plastic and Reconstructive Surgery in Santa Ana, CA. Organization (NPI-2).
NPI number1649745274
StatusActive
Last updated in NPPESOct 10, 2018
Details
- NPI
- 1649745274
- Entity type
- Organization (NPI-2)
- Legal business name
- Eternal Youth Medical Spa
- Organization subpart
- Yes
- Enumeration date
- Oct 10, 2018
- Last updated
- Oct 10, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0122X | Surgery, Plastic and Reconstructive Surgery | – | – | Yes |
Other names
- Mark A.F. Knight, M.D. (Doing Business As)
Practice location
902 N. Grand AvenueSuite 204
Santa Ana, CA 92701
Phone 714-558-9800 · Fax 714-558-9803
Mailing address
902 N. Grand AvenueSuite 204
Santa Ana, CA 92701
Phone 714-558-9800 · Fax 714-558-9803
Authorized official
Maria Jett Knight
Office Director
7145589800
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