Organization
COMPLETE SKIN LA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRA STOTLAND MD (PRESIDENT)
(818) 385-1529
Entity
Organization
Contact information
Practice address
16030 VENTURA BLVD, SUITE 140, ENCINO, CA 91436-2731
(818) 385-1529
(818) 385-1536
Mailing address
16030 VENTURA BLVD, SUITE 140, ENCINO, CA 91436-2731
(818) 385-1529
(818) 385-1536
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
02/26/2015
Last updated
05/18/2015
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