| NPI | 1932084837 |
|---|---|
| Doing Business As | LUMEN SKINLAB |
| Entity Type | Organization |
| Authorized Contact | TRACY WIEGAND CFO & Secretary 949-414-8426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 208200000X Plastic Surgery | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2025-08-08 |
| Last Update Date | 2025-08-12 |