Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI # | 1891103446 |
| LBN Legal business name | 758 MEDICAL SERVICES PC |
| Authorized official | SEONGPAN SI - (PRESIEDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/28/2014 |
| Last updated | 07/28/2014 - About 12 years ago |
| Identifiers | n/a |
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758 MEDICAL SERVICES PC
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