# GRACE DERMATOLOGY

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

## Provider details

- **NPI number:** 1467231811
- **Authorized official:** DR. LINA KENNEDY MD (CEO)
- **Authorized official phone:** (310) 430-8442

## Contact information

- **Practice address:** 5122 KATELLA AVE, LOS ALAMITOS, CA 90720-2826
- **Practice address phone:** (562) 340-5566
- **Mailing address:** 4981 MYRA AVE, CYPRESS, CA 90630-4335
- **Mailing address phone:** (310) 430-8442

## Taxonomy

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

## Other

- **Enumeration date:** 09/25/2023
- **Last updated:** 09/25/2023