Organization · NPI-2
Vitalskin Clinic
Clinic/Center · Valley Village, CA
NPI number1750290730
StatusActive
Last updated in NPPESSep 4, 2026
Details
- NPI
- 1750290730
- Entity type
- Organization (NPI-2)
- Legal business name
- Vitalskin Clinic
- Organization subpart
- No
- Enumeration date
- Sep 4, 2026
- Certification date
- Sep 4, 2026
- Last updated
- Sep 4, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
5301 Laurel Canyon Blvd Ste 116Valley Village, CA 91607-2763
Phone 949-628-4115
Mailing address
5301 Laurel Canyon Blvd Ste 116Valley Village, CA 91607-2763
Phone 949-628-4115
Authorized official
Nattapong Lertwanarin
Ceo
9496284115
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