Organization
TIEV MEDICAL AESTHETICS, A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY GOODMAN MD (PRESIDENT)
(714) 261-6540
Entity
Organization
Contact information
Practice address
230 E 17TH ST STE 200, COSTA MESA, CA 92627-7326
(714) 340-7861
Mailing address
230 E 17TH ST STE 200, COSTA MESA, CA 92627-7326
(714) 340-7861
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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