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Organization

BRAY PLASTIC SURGERY MEDICAL CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID FRAY MD (DIRECTOR)
(310) 534-8300
Entity
Organization

Contact information

Practice address
5 HOLLAND STE 101, IRVINE, CA 92618-2568
(949) 588-2199
(949) 588-2199
Mailing address
23560 MADISON ST STE 102, TORRANCE, CA 90505-4709
(310) 534-8300
(949) 588-2199

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
FNP35839
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
FNP35839
STATE OF CALIFORNIA LICENSE
CA
Enumeration date
08/29/2008
Last updated
08/29/2008
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