# DERMATOLOGY & COSMETIC CARE, A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366629800
- **Authorized official:** BRIAN RACKOHN (BUSINESS MANAGER)
- **Authorized official phone:** (805) 497-8080

## Contact information

- **Practice address:** 425 HAALAND DR., SUITE \#204, THOUSAND OAKS, CA 91361
- **Practice address phone:** (805) 497-8080
- **Practice address fax:** (805) 497-8806
- **Mailing address:** 425 HAALAND DR., SUITE \# 204, THOUSAND OAKS, CA 91361
- **Mailing address phone:** (805) 497-8080
- **Mailing address fax:** (805) 497-8806

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | A73488 | CA | — |
| 261QM2500X | Medical Specialty Clinic/Center | A73488 | CA | Yes |

## Other

- **Enumeration date:** 01/28/2008
- **Last updated:** 04/09/2008