| NPI | 1245698752 |
|---|---|
| Doing Business As | SHANTHIMD DERMATOLOGY, INC. |
| Entity Type | Organization |
| Authorized Contact | SHANTHI MARIE COLACO CEO/Owner 323-421-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A123314) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A123314) |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2024-07-24 |