| NPI | 1194838441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA DEL VALLE Billing Supervisor 619-462-1670 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207NS0135X Dermatology Procedural Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| 207W00000X Ophthalmology | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2023-12-27 |