Organization
HEAVENLY PLASTIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID NGUYEN MD (CEO)
(310) 980-3715
Entity
Organization
Contact information
Practice address
29300 PORTOLA PKWY, LAKE FOREST, CA 92630-8718
(657) 333-5497
Mailing address
29300 PORTOLA PKWY, LAKE FOREST, CA 92630-8718
(657) 333-5497
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
09/03/2018
Last updated
09/03/2018
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