| NPI | 1104405943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AEGEAN CHAN Owner 805-208-7656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2022-08-19 |