Organization
SSK PLASTIC SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHROOZ SEAN KELISHADI M.D. (OWNER/PRESIDENT)
(949) 395-2266
Entity
Organization
Contact information
Practice address
500 SUPERIOR AVE, 340, NEWPORT BEACH, CA 92663-3657
(949) 515-7874
(949) 650-7874
Mailing address
21163 NEWPORT COAST DR # 132, NEWPORT COAST, CA 92657-1123
(949) 395-2266
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
07/25/2014
Last updated
12/09/2016
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