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Organization

DIVINE PLASTIC SURGERY, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERIC CHAOKO HU MD (OWNER)
(626) 449-3200
Entity
Organization

Contact information

Practice address
713 W DUARTE RD, SUITE G-173, ARCADIA, CA 91007-7564
(626) 449-3200
(626) 782-6198
Mailing address
713 W DUARTE RD, SUITE G-173, ARCADIA, CA 91007-7564
(626) 449-3200
(626) 782-6198

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A84577
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A84577
CA MEDICAL LICENSE
CA
Enumeration date
08/13/2010
Last updated
08/13/2010
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