Organization
BALANCED SKIN DERMATOLOGY AND AESTHETICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUCHISMITA PAUL MD (FOUNDER)
(717) 201-2498
Entity
Organization
Contact information
Practice address
4321 BIRCH ST, NEWPORT BEACH, CA 92660-1923
(717) 201-2498
Mailing address
12542 VISTA PANORAMA, SANTA ANA, CA 92705-1314
(717) 201-2498
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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