| Congress Cosmetic Medical Corp | |
|
10 Congress St Suite # 320 Pasadena CA 91105-3023 | |
| (626) 585-9474 | |
| (626) 585-9480 |
| Full Name | Congress Cosmetic Medical Corp |
|---|---|
| Speciality | Clinic/center |
| Location | 10 Congress St, Pasadena, California |
| Authorized Official Name and Position | Marilyn Ann Mehlmauer (PRESIDENT) |
| Authorized Official Contact | 6265859474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Congress Cosmetic Medical Corp 10 Congress St Suite # 320 Pasadena CA 91105-3023 Ph: (626) 585-9474 | Congress Cosmetic Medical Corp 10 Congress St Suite # 320 Pasadena CA 91105-3023 Ph: (626) 585-9474 |
| NPI Number | 1528129194 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 06/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528129194 | NPI | - | NPPES |
| GO35270 | Other | CA | LICENSE NUMBER |
| W16113 | Other | CA | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | GO35270 (California) | Primary |
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