Organization
SOCAL SKIN AND SURGERY
Active
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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