| NPI | 1083124598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI KRUIDHOF Nurse 562-498-2459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| 207ND0900X Dermatology Dermatopathology | |
| 207NP0225X Dermatology Pediatric Dermatology | |
| 207NS0135X Dermatology Procedural Dermatology | |
| 208200000X Plastic Surgery | |
| 2082S0105X Plastic Surgery Surgery of the Hand | |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2017-10-10 |