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Organization

DERM LOUNGE PC

Active
Other names
Derm Lounge
Organization subpart
No

Provider details

NPI number
Authorized official
MR. FARAH AWADALLA (MEDICAL DIRECTOR)
(714) 337-9393
Entity
Organization

Contact information

Practice address
1713 W KATELLA AVE, ANAHEIM, CA 92804-6450
(714) 798-2900
(949) 216-3232
Mailing address
PO BOX 519, LAKE FOREST, CA 92609-0519
(714) 798-2900
(949) 216-3232

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207NS0135X
Procedural Dermatology Physician
208D00000X
General Practice Physician

Other

Enumeration date
03/11/2024
Last updated
05/27/2025
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