| NPI | 1124166400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA HITE CEO 949-631-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA a69586) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A69586) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A69586) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2012-01-19 |