| NPI | 1689319204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI GOODARZI President/Owner 949-412-9450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2022-07-12 |