Organization
SIMON MADORSKY M.D A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALINDA VANCE (SUPERVISOR BILLING SUPPORT SERVICES)
(949) 574-4652
Entity
Organization
Contact information
Practice address
180 NEWPORT CENTER DR, SUITE 158, NEWPORT BEACH, CA 92660-6972
(949) 719-1800
(949) 719-1810
Mailing address
PO BOX 15788, NEWPORT BEACH, CA 92659-5788
(949) 574-4638
(949) 574-4680
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
A50075
CA
Other
Enumeration date
10/07/2008
Last updated
01/31/2012
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