| NPI | 1225366610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE MARIE MCNEILL Owner 714-227-6276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2017-10-12 |