Organization
SUNDINE CENTER FOR FACIAL AESTHETICS AND PLASTIC SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JAMES SUNDINE M.D. (PRESIDENT)
(949) 706-3100
Entity
Organization
Contact information
Practice address
1640 NEWPORT BLVD, SUITE 450, COSTA MESA, CA 92627-3786
(949) 706-3100
(949) 706-3265
Mailing address
PO BOX 54370, IRVINE, CA 92619-4370
(949) 706-3100
(949) 706-3265
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
G66233
CA
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
G66233
CA
Other
Enumeration date
05/09/2014
Last updated
05/09/2014
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