| NPI | 1922101971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL E GORMLEY Owner President 626-963-7684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A21148) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A21148) |
| 207ND0900X Dermatology, Dermatopathology (Licence: CA A21148) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A21148) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2008-02-19 |