| NPI | 1902988272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIEM QUYNH PHAM CEO 909-392-3230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology Procedural Dermatology (Licence: CA 20A7309) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2008-02-10 |