| NPI | 1114198975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARL DAVID BASSLER President 949-855-3376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A64015) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: CA A64015) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A64015) | |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2023-03-07 |