Individual provider · NPI-1

Dr. Jennifer Channual

Dermatology · Laguna Hills, CA

NPI number1689986374
StatusActive
Last updated in NPPESFeb 20, 2019

Details

NPI
1689986374
Entity type
Individual (NPI-1)
Name
Dr. Jennifer Channual
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 9, 2010
Last updated
Feb 20, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X Dermatologya116489CAYes

Practice location

23521 Paseo De Valencia Ste 102
Laguna Hills, CA 92653

Phone 949-520-1815

Mailing address

23521 Paseo De Valencia Ste 102
Laguna Hills, CA 92653-3126

Other practice locations

360 San Miguel Dr Ste 501
Newport Beach, CA 92660

Phone 949-720-1170

360 San Miguel Dr Ste 501
Newport Beach, CA 92660

Phone 949-720-1170

23521 Paseo De Valencia Ste 102
Laguna Hills, CA 92653

Phone 949-520-1815

23521 Paseo De Valencia Ste 102
Laguna Hills, CA 92653

Phone 949-520-1815

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