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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