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Organization

FORM MD PLASTIC SURGERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAYLOR R POLLEI MD (CEO/PROVIDER)
(949) 998-2020
Entity
Organization

Contact information

Practice address
26691 PLAZA STE 200, MISSION VIEJO, CA 92691-8582
(949) 998-2020
Mailing address
26691 PLAZA STE 200, MISSION VIEJO, CA 92691-8582
(949) 998-2020
(949) 998-2021

Taxonomy

Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
208600000X
Surgery Physician
261QM2500X
Medical Specialty Clinic/Center

Other

Enumeration date
01/29/2020
Last updated
04/26/2023
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