| NPI | 1831603901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN GRAYMAN President 760-341-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology Procedural Dermatology (Licence: CA G29724) |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2018-06-16 |