| NPI | 1790246841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIVYA SHOKEEN Owner 310-847-9693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2024-02-22 |