Organization
SKIN CANCER AND RECONSTRUCTIVE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMON JOSEPH MADORSKY M.D. (OWNER)
(949) 200-1600
Entity
Organization
Contact information
Practice address
180 NEWPORT CENTER DR, SUITE 157, NEWPORT BEACH, CA 92660-6972
(949) 200-1600
(949) 200-1610
Mailing address
180 NEWPORT CENTER DR, SUITE 157, NEWPORT BEACH, CA 92660-6972
(949) 200-1600
(949) 200-1610
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2009
Last updated
01/23/2019
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