Organization
MODERN INTITUTE OF PLASTIC SURGERY & ANTI-AGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN A. STANTON M.D. (MEDICAL DIRECTOR)
(310) 278-0077
Entity
Organization
Contact information
Practice address
9090 BURTON WAY, BEVERLY HILLS, CA 90211-1661
(310) 278-0077
Mailing address
9090 BURTON WAY, BEVERLY HILLS, CA 90211-1661
(310) 278-0077
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
C2780128
CA
Other
Enumeration date
12/27/2007
Last updated
12/06/2013
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