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Organization
LUMINOUS SKIN DERMATOLOGY AND COSMETIC INSTITUTE INC
Active
Organization
LUMINOUS SKIN DERMATOLOGY AND COSMETIC INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRIA V BOOTH MD (PRESIDENT)
(310) 374-3100
Entity
Organization
Contact information
Practice address
119 W TORRANCE BLVD, SUITE 7, REDONDO BEACH, CA 90277-3600
(310) 374-3100
(310) 374-3155
Mailing address
119 W TORRANCE BLVD, SUITE 7, REDONDO BEACH, CA 90277-3600
(310) 374-3100
(310) 374-3155
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
FNP40648
CA
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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