Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Craniofacial/Cleft Palate Program

Organization Specialist · NPI 1093959900

Craniofacial/Cleft Palate Program is a Specialist in Los Angeles, California. Registered with an NPI since 2009.

In the registry since
2009

Practice location Address checks out

403 W Adams Blvd 4th Fl
Los Angeles, CA 90007-2664
Phone: (213) 742-1433
Fax: (213) 742-1496
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1093959900
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Libby Wilson — Plastic Surgeon · (213) 742-1433
Other names Cleft Palate Program Medical Practice Group
NPI enumeratedApril 22, 2009
Last updated in NPPESAugust 18, 2015
Mailing address403 W Adams Blvd, 4th Floor, Los Angeles, CA 90007-2664

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