Individual
DR. LEILA ETTEFAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
360 SAN MIGUEL DR, SUITE 501, NEWPORT BEACH, CA 92660-7853
(949) 720-1170
(949) 720-1172
Mailing address
360 SAN MIGUEL DR, SUITE 501, NEWPORT BEACH, CA 92660-7853
(949) 720-1170
(949) 720-1172
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A89632
CA
Other
Enumeration date
05/08/2006
Last updated
02/15/2012
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