# CAPISTRANO SKIN CANCER CENTER, INC

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

## Provider details

- **NPI number:** 1659739837
- **Authorized official:** DAWN MARIE LEIVA (MANAGER)
- **Authorized official phone:** (949) 248-1632

## Contact information

- **Practice address:** 30280 RANCHO VIEJO RD, SAN JUAN CAPISTRANO, CA 92675-1561
- **Practice address phone:** (949) 248-1632
- **Mailing address:** 30280 RANCHO VIEJO RD, SAN JUAN CAPISTRANO, CA 92675-1561
- **Mailing address phone:** (949) 248-1632

## Taxonomy

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

## Other

- **Enumeration date:** 02/03/2016
- **Last updated:** 07/21/2022