NPI | 1306940465 |
---|---|
Entity Type | Organization |
Authorized Contact | REZA BABAPOUR Md Owner 310-247-0337 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA G77137) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA G77137) |
Enumeration Date | 2006-09-11 |
Last Update Date | 2016-03-10 |