# AESTHETIC SURGERY & LASER MEDICAL CENTER INC

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

## Provider details

- **NPI number:** 1467572115
- **Authorized official:** DR. BERNARD I RASKIN MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (661) 254-3686

## Contact information

- **Practice address:** 28212 KELLY JOHNSON PKWY, SUITE 265, VALENCIA, CA 91355-5084
- **Practice address phone:** (661) 254-3686
- **Practice address fax:** (661) 254-5671
- **Mailing address:** 28212 KELLY JOHNSON PKWY, SUITE 265, VALENCIA, CA 91355-5084
- **Mailing address phone:** (661) 254-3686
- **Mailing address fax:** (661) 254-5671

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/29/2007
- **Last updated:** 07/16/2015