Organization
WILSHIRE CO MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BUN BRIAN SIU MD (CEO)
(213) 384-3435
Entity
Organization
Contact information
Practice address
3435 WILSHIRE BLVD STE 500, LOS ANGELES, CA 90010-1906
(213) 384-3435
Mailing address
3435 WILSHIRE BLVD STE 500, LOS ANGELES, CA 90010-1906
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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