Organization
BLUE PACIFIC AESTHETIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS ROY MEST M.D. (PRESIDENT)
(714) 347-1010
Entity
Organization
Contact information
Practice address
415 PIER AVE, HERMOSA BEACH, CA 90254-3820
(310) 379-6074
Mailing address
210 N TUSTIN AVE, SANTA ANA, CA 92705-3807
(800) 883-7243
(714) 647-1245
Taxonomy
Speciality
Code
Description
License number
State
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
FNP27928
CA
Other
Enumeration date
05/25/2006
Last updated
05/04/2010
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