| NPI | 1366629800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN RACKOHN Business Manager 805-497-8080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A73488) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A73488) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-04-09 |