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General NPI Number Information
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NPI Number | 1215407614
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Entity Type | Organization
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Legal Business Name | ADVANCED HAND & RECONSTRUCTIVE PLASTIC SURGERY INC.
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Dates
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Enumeration Date | 11/28/2018
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Last Update Date | 11/28/2018
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Provider Practice Location Address
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Address Line | 18546 ROSCOE BLVD STE 220
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City | NORTHRIDGE
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State | CA
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Zip | 91324-5455
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Country | US
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Telephone | 661-326-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 9227 RESEDA BLVD # 505
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City | NORTHRIDGE
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State | CA
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Zip | 91324-3137
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Country | US
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Telephone | 661-326-2800
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ABDUL-WAHAB H SHARARAH
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Credential | MD
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Telephone | 661-326-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number |
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License Number State |
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