Organization
SOUTHERN CALIFORNIA CENTER FOR ANTI AGING, INC.
Active
Other names
SOUTHERN CALIFORNIA CENTER FOR ANTI AGING
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL PATRICK GOLDSTONE (CHIEF OPERATING OFFICER)
(805) 637-0232
Entity
Organization
Contact information
Practice address
23823 HAWTHORNE BLVD, TORRANCE, CA 90505-5907
(424) 247-4962
Mailing address
23823 HAWTHORNE BLVD, TORRANCE, CA 90505-5907
(424) 247-4962
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
G42196
CA
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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