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Organization

PENINSULA PLASTIC SURGERY MEDICAL GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE BUTLER (AUTHORIZED OFFICIAL)
(415) 713-4341
Entity
Organization

Contact information

Practice address
1750 EL CAMINO REAL STE 405, BURLINGAME, CA 94010-3217
(650) 692-0467
Mailing address
1750 EL CAMINO REAL STE 405, BURLINGAME, CA 94010-3217
(650) 692-0467

Taxonomy

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

Other

Enumeration date
03/21/2024
Last updated
03/21/2024
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