Organization
SOCAL SKIN AND SURGERY
Active
Other names
SoCal Skin and Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNY ZHUOYUE WANG MD (DERMATOLOGIST)
(240) 246-3164
Entity
Organization
Contact information
Practice address
12555 W JEFFERSON BLVD STE 202, LOS ANGELES, CA 90066-7047
(424) 543-0066
Mailing address
12555 W JEFFERSON BLVD STE 202, LOS ANGELES, CA 90066-7047
(424) 543-0066
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679036719
—
CA
Enumeration date
03/06/2023
Last updated
07/04/2023
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