Organization
LA SKIN CARE CENTER A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAISA HOWARD C.N.P (OWNER)
(310) 826-1101
Entity
Organization
Contact information
Practice address
12304 SANTA MONICA BLVD, SUITE 208, LOS ANGELES, CA 90025-2551
(310) 826-1101
(310) 826-0181
Mailing address
12304 SANTA MONICA BLVD, SUITE 208, LOS ANGELES, CA 90025-2551
(310) 826-1101
(310) 826-0181
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
G24428
CA
Other
Enumeration date
10/19/2009
Last updated
10/19/2009
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