Organization
KOHLI PLASTIC SURGERY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GURMANDER S. KOHLI MD (CEO/PRESIDENT)
(949) 954-8382
Entity
Organization
Contact information
Practice address
11100 WARNER AVE, SUITE 206, FOUNTAIN VALLEY, CA 92708-7506
(949) 954-8382
(949) 272-0430
Mailing address
15 PHOTINIA, IRVINE, CA 92620-2218
(949) 954-8382
(949) 272-0430
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
C51411
CA
Other
Enumeration date
06/09/2010
Last updated
01/22/2012
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