Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | A34927 | CA |
NPI | 1710035654 |
---|---|
Provider Name | Paul Surapol |
First Address | Bellflower, CA 90706-2246 |
Second Address | Bellflower, CA 90706-2246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 23/09/2008 |