| NPI | 1881706919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL JOHN MARNELL Owner/President 619-287-1549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA C33369) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-12-30 |