Organization
CONGRESS COSMETIC MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARILYN ANN MEHLMAUER MD (PRESIDENT)
(626) 585-9474
Entity
Organization
Contact information
Practice address
10 CONGRESS ST, SUITE # 320, PASADENA, CA 91105-3023
(626) 585-9474
(626) 585-9480
Mailing address
10 CONGRESS ST, SUITE # 320, PASADENA, CA 91105-3023
(626) 585-9474
(626) 585-9480
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
GO35270
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GO35270
LICENSE NUMBER
CA
01
—
W16113
PTAN
CA
Enumeration date
12/13/2006
Last updated
06/29/2016
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