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Organization
SKIN CANCER AND RECONSTRUCTIVE SURGERY CENTER, LLC
Active
Organization
SKIN CANCER AND RECONSTRUCTIVE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMON JOSEPH MADORSKY M.D. (OWNER)
(949) 200-1600
Entity
Organization
Contact information
Practice address
180 NEWPORT CENTER DR, SUITE 157, NEWPORT BEACH, CA 92660-6972
(949) 200-1600
(949) 200-1610
Mailing address
180 NEWPORT CENTER DR, SUITE 157, NEWPORT BEACH, CA 92660-6972
(949) 200-1600
(949) 200-1610
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
04/24/2009
Last updated
01/23/2019
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