Organization
GRACE DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINA KENNEDY MD (CEO)
(310) 430-8442
Entity
Organization
Contact information
Practice address
5122 KATELLA AVE, LOS ALAMITOS, CA 90720-2826
(562) 340-5566
Mailing address
4981 MYRA AVE, CYPRESS, CA 90630-4335
(310) 430-8442
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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