Organization
LUIS H. MACIAS MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANS G MILIAN (TREASURER)
(858) 480-6772
Entity
Organization
Contact information
Practice address
13924 MARQUESAS WAY APT 1524, MARINA DEL REY, CA 90292-6018
(310) 574-2103
(310) 640-6069
Mailing address
8605 SANTA MONICA BLVD # 91818, LOS ANGELES, CA 90069-4109
(310) 574-2103
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518170950
NPI
—
Enumeration date
03/13/2018
Last updated
03/13/2018
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