Organization
J S VINCENT MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BUTORA (BILLING MANAGER)
(562) 787-0225
Entity
Organization
Contact information
Practice address
3111 LOS FELIZ BLVD STE 103, LOS ANGELES, CA 90039-1599
(770) 895-8483
Mailing address
3111 LOS FELIZ BLVD STE 103, LOS ANGELES, CA 90039-1599
(770) 895-8483
Taxonomy
Speciality
Code
Description
License number
State
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
—
—
Other
Enumeration date
10/17/2020
Last updated
10/18/2020
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