Organization
RECONSTRUCTIVE SERVICES MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN R ALLISON M.D. (PRESIDENT)
(714) 633-9761
Entity
Organization
Contact information
Practice address
212 E CHAPMAN AVE, ORANGE, CA 92866-1506
(714) 633-9761
(714) 633-0802
Mailing address
212 E CHAPMAN AVE, ORANGE, CA 92866-1506
(714) 633-9761
(714) 633-0802
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
G25063
CA
2086S0122X
Plastic and Reconstructive Surgery Physician
G25063
CA
2086X0206X
Surgical Oncology Physician
Primary
G25063
CA
Other
Enumeration date
01/25/2007
Last updated
09/11/2025
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