Organization
EOTI
Active
Other names
Plastic Surgery Institute of Southern California
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD OWEN TERINO M.D. (MEDICAL DIRECTOR)
(805) 495-1043
Entity
Organization
Contact information
Practice address
327 S MOORPARK RD, THOUSAND OAKS, CA 91361-1008
(805) 495-1043
Mailing address
327 S MOORPARK RD, THOUSAND OAKS, CA 91361-1008
(805) 495-1043
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
G014784
CA
Other
Enumeration date
05/03/2007
Last updated
07/07/2015
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