Illuminate Plastic Surgery, INC
NPI #1114384518 in Palo Alto, California
Provider Information
- NPI Number
- 1114384518
- Entity Type
- Organization
- Organization Name
- Illuminate Plastic Surgery, INC
- Primary Specialty
- Clinic/Center - Medical Specialty
- Enumeration Date
- Jan 15, 2016
- Last Updated
- Jan 15, 2016
Practice Location
- Address
- 1515 EL CAMINO REAL STE C
- City
- Palo Alto
- State
- California
- ZIP Code
- 94306-1000
- Phone
- (650) 433-8621
Authorized Official
- Name
- DR. DAVID J BOUDREAULT, M.D.
- Title
- OWNER
- Phone
- (650) 433-8621
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Medical Specialty — Medical Specialty |
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