Organization
MENLO PARK PLASTIC SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAL BAGWAT M.D. (PRESIDENT)
(650) 322-2443
Entity
Organization
Contact information
Practice address
631 MENLO AVE, MENLO PARK, CA 94025-4701
(650) 322-2443
Mailing address
631 MENLO AVE, MENLO PARK, CA 94025-4701
(650) 322-2443
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
3030
CA
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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