# LUMINOUS SKIN DERMATOLOGY AND COSMETIC INSTITUTE INC

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

## Provider details

- **NPI number:** 1982904892
- **Authorized official:** ALEXANDRIA V BOOTH MD (PRESIDENT)
- **Authorized official phone:** (310) 374-3100

## Contact information

- **Practice address:** 119 W TORRANCE BLVD, SUITE 7, REDONDO BEACH, CA 90277-3600
- **Practice address phone:** (310) 374-3100
- **Practice address fax:** (310) 374-3155
- **Mailing address:** 119 W TORRANCE BLVD, SUITE 7, REDONDO BEACH, CA 90277-3600
- **Mailing address phone:** (310) 374-3100
- **Mailing address fax:** (310) 374-3155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | FNP40648 | CA | Yes |

## Other

- **Enumeration date:** 10/26/2010
- **Last updated:** 10/26/2010