Organization
SPADE SKIN CARE MEDICAL INC
Active
Organization
SPADE SKIN CARE MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN O'NEIL SIMMONDS M.D. (PRESIDENT)
(310) 316-1954
Entity
Organization
Contact information
Practice address
1611 S CATALINA AVE STE L70, REDONDO BEACH, CA 90277-5296
(310) 316-1954
(310) 504-1739
Mailing address
1611 S CATALINA AVE STE L70, REDONDO BEACH, CA 90277-5296
(310) 316-1954
(310) 504-1739
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A100364
CA
Other
Enumeration date
03/08/2017
Last updated
03/08/2017
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