Organization
RYAN SPIVAK INTEGRATIVE PLASTIC SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN M SPIVAK M.D (AUTHORIZED OFFICIAL)
(310) 905-3331
Entity
Organization
Contact information
Practice address
2200 W 3RD ST, SUITE 120A, LOS ANGELES, CA 90057-1932
(310) 739-3197
Mailing address
PO BOX 46666, LOS ANGELES, CA 90046-0666
(310) 739-3197
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
A113632
CA
Other
Enumeration date
02/16/2016
Last updated
05/05/2017
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