| NPI | 1427114032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TABIBIAN Owner 310-738-6006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2019-10-24 |