# SOUTHERN CALIFORNIA CENTER FOR ANTI AGING, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SOUTHERN CALIFORNIA CENTER FOR ANTI AGING
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215366455
- **Authorized official:** MR. DANIEL PATRICK GOLDSTONE (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (805) 637-0232

## Contact information

- **Practice address:** 23823 HAWTHORNE BLVD, TORRANCE, CA 90505-5907
- **Practice address phone:** (424) 247-4962
- **Mailing address:** 23823 HAWTHORNE BLVD, TORRANCE, CA 90505-5907
- **Mailing address phone:** (424) 247-4962

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | G42196 | CA | Yes |

## Other

- **Enumeration date:** 11/07/2013
- **Last updated:** 11/07/2013