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General NPI Number Information
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NPI Number | 1033076468
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Entity Type | Organization
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Legal Business Name | STANDARD OF MODERN AESTHETICS MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 333 S ARROYO PKWY FL 3
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City | PASADENA
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State | CA
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Zip | 91105-2581
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Country | US
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Telephone | 310-860-8916
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Fax |
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Provider Business Mailing Address
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Address Line | 333 S ARROYO PKWY FL 3
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City | PASADENA
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State | CA
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Zip | 91105-2581
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SURGEON
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Name | LEIF ROGERS
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Credential | MD
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Telephone | 310-860-8915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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