Organization
DM LASER AND DERMA CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRICK MACALINTAL (CEO)
(310) 863-3433
Entity
Organization
Contact information
Practice address
246 W COLLEGE ST FL 3, COVINA, CA 91723-1910
(626) 915-1911
(626) 915-2668
Mailing address
246 W COLLEGE ST FL 3, COVINA, CA 91723-1910
(626) 915-1911
(626) 915-2668
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003434275
MEDICAL
CA
Enumeration date
02/20/2024
Last updated
02/20/2024
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