| NPI | 1073055257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAMAD BAGHERI Sole Member/Owner 951-500-7286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2016-11-05 |
| Last Update Date | 2016-11-05 |