| NPI | 1396984423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA J GLENN President 310-821-7658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA g63373) |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology (Licence: CA g63373) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2018-10-26 |