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Organization
SOUTHERN CALIFORNIA SKIN AND LASER
Active
Organization
SOUTHERN CALIFORNIA SKIN AND LASER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANYA Y EVANS M.D. (MEDICAL DIRECTOR)
(949) 707-5734
Entity
Organization
Contact information
Practice address
22972 MOULTON PKWY STE 106, LAGUNA HILLS, CA 92653-1219
(949) 707-5734
(949) 707-1924
Mailing address
22972 MOULTON PKWY STE 106, LAGUNA HILLS, CA 92653-1219
(949) 707-5734
(949) 707-1924
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A68285
CA
Other
Enumeration date
10/15/2007
Last updated
10/15/2007
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