Organization
PLASTIKKIRURGI, INC.
Active
Other names
Charlotta La Via, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
SHERYL SANTOS (DELEGATED OFFICIAL)
(310) 592-0266
Entity
Organization
Contact information
Practice address
2001 SANTA MONICA BLVD STE 1180W, SANTA MONICA, CA 90404-2215
(310) 829-5550
(310) 829-5502
Mailing address
2001 SANTA MONICA BLVD STE 1180W, SANTA MONICA, CA 90404-2215
(310) 592-0266
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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