| NPI | 1093035479 |
|---|---|
| Other Name | AVA MD MED SPA |
| Entity Type | Organization |
| Authorized Contact | AVA THERESA SHAMBAN Doctor/Owner 310-828-2282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2010-10-13 |