NPI 1003369380

Integrative Medical Group, INC

Organisation Plastic and Reconstructive Surgery Physician Los Angeles, CA

Practice location

Address: 2200 W 3rd St Suite 120 a, Los Angeles, CA 90057-1932
Phone: (310) 905-3331
Fax: (310) 453-2916

Authorised official

Name: Ryan M Spivak
Title: Authorized Official
Phone: (310) 905-3331

Registered specialties

Plastic and Reconstructive Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2086S0122X Licence A113632 (CA)

Other Surgery providers in California →

Registry record

NPI: 1003369380
Entity type: Organization
NPI issued: 3 Aug 2016
Record last updated: 3 Aug 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.