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NPI Code Detail

MEDICARE: FACESPLUS INC

MEDICARE: FACESPLUS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208200000XPlastic Surgery Physician

General Provider Information

NPI Number : 1700913902
Entity Type Code : Organization
Provider Name (Legal Business Name) : FACESPLUS INC
Provider Business Mailing Address
First Line : 4510 EXECUTIVE DR STE 200
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-3023
Country : US
Telephone Number : 858-842-2370
Fax Number : 858-842-2375
Provider Business Practice Location Address
First Line : 4510 EXECUTIVE DR STE 200
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-3023
Country : US
Telephone Number : 858-842-2370
Fax Number : 858-842-2375
Authorized Official
Title or Position : OWNER
Name : STEVEN R COHEN
Credential : MD
Telephone Number : 858-842-2370
Provider Enumeration Date : 02/27/2007
Last Update Date : 04/13/2011

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Directions to “FACESPLUS INC ” Practice Location

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