| NPI | 1972120194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL K OBENG Medical Director 310-275-2705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2020-07-03 |
| Last Update Date | 2020-07-03 |