CRANIOFACIAL/CLEFT PALATE PROGRAM is a specialist in Los Angeles, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. CRANIOFACIAL/CLEFT PALATE PROGRAM NPI is 1093959900. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Cleft Palate Program Medical Practice Group.
The provider's business location address is:
403 W ADAMS BLVD
4TH FLOOR
LOS ANGELES, CA
ZIP 90007-664
Phone: (213) 742-1433
Fax: (213) 742-1496
The provider's authorized official is Libby F Wilson .
The authorized official title is Plastic Surgeon and has the following contact phone number (213) 742-1433.
The enumeration date for this NPI number is 4/22/2009 and was last updated on 8/18/2015.