Organization
PREMIER PLASTIC SURGERY CENTER
Active
Other names
Trident Mountain LP
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WINDY HE (PRACTICE MANGER)
(650) 321-7100
Entity
Organization
Contact information
Practice address
1795 EL CAMINO REAL, SUITE 200, PALO ALTO, CA 94306-1164
(650) 321-7100
(650) 323-3220
Mailing address
1795 EL CAMINO REAL, SUITE 200, PALO ALTO, CA 94306-1164
(650) 321-7100
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3388
AAAASF
CA
Enumeration date
05/02/2012
Last updated
01/23/2017
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