Provider Demographics
NPI:1588808463
Name:AESTHETIC ARTS INSTITUTE OF PLASTIC SURGERY, LLC
Entity Type:Organization
Organization Name:AESTHETIC ARTS INSTITUTE OF PLASTIC SURGERY, LLC
Other - Org Name:LA MESA MEDICAL & SURGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAWESKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-464-9876
Mailing Address - Street 1:8401 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5303
Mailing Address - Country:US
Mailing Address - Phone:619-464-9876
Mailing Address - Fax:619-464-9877
Practice Address - Street 1:8415 GRANT AVENUE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941
Practice Address - Country:US
Practice Address - Phone:619-464-9876
Practice Address - Fax:619-464-9877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53909261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical