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Organization
PLASTIC SURGERY BODY CONTOURING
Active
Organization
PLASTIC SURGERY BODY CONTOURING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIAMAK AGHA MOHAMMADI M.D. (CEO)
(949) 644-2442
Entity
Organization
Contact information
Practice address
2121 E COAST HWY, SUITE 260, CORONA DEL MAR, CA 92625-1931
(949) 644-2442
(949) 644-2402
Mailing address
2121 E COAST HWY, SUITE 260, CORONA DEL MAR, CA 92625-1931
(949) 644-2442
(949) 644-2402
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A92742
CA
Other
Enumeration date
05/17/2011
Last updated
05/17/2011
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