| NPI | 1891075123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN CALAME MILLER N.P./Secretary 714-313-9668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A97816) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2012-03-29 |