| NPI | 1083631808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRIE J KLEIN President 949-363-1788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G58945) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G58945) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA G58945) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: CA G58945) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2015-03-11 |