| NPI | 1861656563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE S LIU Owner 949-863-0988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A061446) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2023-09-12 |