# PLASTICARE SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Plasticare Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437402054
- **Authorized official:** IKONIJA SEKULOVICH JOY MD (DIRECTOR PLASTICARE SURGERY CENTER)
- **Authorized official phone:** (562) 427-8944

## Contact information

- **Practice address:** 920 EAST WARDLOW ROAD, LONG BEACH, CA 90807-4630
- **Practice address phone:** (562) 427-8944
- **Practice address fax:** (562) 427-4086
- **Mailing address:** 920 EAST WARDLOW ROAD, LONG BEACH, CA 90807-4630
- **Mailing address phone:** (562) 427-8944
- **Mailing address fax:** (562) 427-4086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208200000X | Plastic Surgery Physician | G25370 | CA | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 1386(AAAASF) | IL | Yes |

## Other

- **Enumeration date:** 10/19/2012
- **Last updated:** 10/19/2012