# GLOW THEORY DERMATOLOGY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Glow Theory - Dermatology Studio
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477221364
- **Authorized official:** INSIYAH DARUGAR FNP (FAMILY NURSE PRACTITIONER)
- **Authorized official phone:** (859) 912-1906

## Contact information

- **Practice address:** 7750 EL CAMINO REAL STE F, CARLSBAD, CA 92009-8517
- **Practice address phone:** (888) 456-9843
- **Mailing address:** 7750 EL CAMINO REAL STE F, CARLSBAD, CA 92009-8517
- **Mailing address phone:** (888) 456-9843

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0100X | Health Service Clinic/Center | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 09/03/2021
- **Last updated:** 09/03/2021