San Diego Skin, INC.
Clinic/Center, Ambulatory Surgical in La Jolla, CA. Organization (NPI-2).
NPI number1972831998
StatusActive
Last updated in NPPESDec 2, 2009
Details
- NPI
- 1972831998
- Entity type
- Organization (NPI-2)
- Legal business name
- San Diego Skin, INC.
- Organization subpart
- No
- Enumeration date
- Dec 2, 2009
- Last updated
- Dec 2, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QA1903X | Clinic/Center, Ambulatory Surgical | A83432 | CA | Yes |
Practice location
4150 Regents Park RowSuite 300
La Jolla, CA 92037-9124
Phone 858-909-9000 · Fax 858-909-9009
Mailing address
4150 Regents Park RowSuite 300
La Jolla, CA 92037-9124
Phone 858-909-9000 · Fax 858-909-9009
Authorized official
M. Mark Mofid
President
8589099000
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