| NPI | 1881890580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENORE S KAKITA President 626-584-9933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A23000) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NV 11979) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2020-08-22 |