Organization
GOLDEN COAST PLASTIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK ULVILA MD (CEO)
(347) 770-5891
Entity
Organization
Contact information
Practice address
133 ARCH ST STE 4, REDWOOD CITY, CA 94062-1326
(347) 770-5891
Mailing address
133 ARCH ST STE 4, REDWOOD CITY, CA 94062-1326
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
11/02/2018
Last updated
11/02/2018
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