| NPI | 1235792219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCI LYNN COLE Office Administrator 949-439-9288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology | |
| 207NP0225X Dermatology, Pediatric Dermatology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2019-04-16 |