# MENLO PARK PLASTIC SURGERY CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023262417
- **Authorized official:** BAL BAGWAT M.D. (PRESIDENT)
- **Authorized official phone:** (650) 322-2443

## Contact information

- **Practice address:** 631 MENLO AVE, MENLO PARK, CA 94025-4701
- **Practice address phone:** (650) 322-2443
- **Mailing address:** 631 MENLO AVE, MENLO PARK, CA 94025-4701
- **Mailing address phone:** (650) 322-2443

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 3030 | CA | Yes |

## Other

- **Enumeration date:** 11/11/2008
- **Last updated:** 11/11/2008