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Organization

PLASTICARE SURGERY CENTER LLC

Active
Other names
Plasticare Surgery Center
Organization subpart
No

Provider details

NPI number
Authorized official
IKONIJA SEKULOVICH JOY MD (DIRECTOR PLASTICARE SURGERY CENTER)
(562) 427-8944
Entity
Organization

Contact information

Practice address
920 EAST WARDLOW ROAD, LONG BEACH, CA 90807-4630
(562) 427-8944
(562) 427-4086
Mailing address
920 EAST WARDLOW ROAD, LONG BEACH, CA 90807-4630
(562) 427-8944
(562) 427-4086

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
G25370
CA
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1386(AAAASF)
IL

Other

Enumeration date
10/19/2012
Last updated
10/19/2012
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