| NPI | 1588612816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHAN QUAN NGUYEN Medical Director 951-682-9293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA G77748) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2013-08-01 |