Individual
CONG RAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1317 5TH ST STE 300, SANTA MONICA, CA 90401-1433
(310) 434-0044
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
A167718
CA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
A167718
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2015
Last updated
04/06/2021
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