Organization
ELITE PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEENETH B HUGHES MD (MEDICAL DIRECTOR)
(310) 275-4170
Entity
Organization
Contact information
Practice address
12732 W WASHINGTON BLVD STE B, LOS ANGELES, CA 90066-2378
(310) 275-4170
Mailing address
12732 W WASHINGTON BLVD STE B, LOS ANGELES, CA 90066-2378
(310) 275-4170
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/16/2016
Last updated
11/16/2016
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