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ADVANCE DERMATOLOGY AND LASER MEDICAL CENTER INC. NPI 1396849576


NPI Information

NPI: 1396849576
Provider Name: ADVANCE DERMATOLOGY AND LASER MEDICAL CENTER INC.
Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

CLIA Number: 05D0939439

Address:
4560 ADMIRALTY WAY STE 101
MARINA DEL REY, CA
ZIP 90292
Phone: (310) 577-7544
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ADVANCE DERMATOLOGY AND LASER MEDICAL CENTER INC. is a procedural dermatology dermatology in Marina Del Rey, CA. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). ADVANCE DERMATOLOGY AND LASER MEDICAL CENTER INC. NPI is 1396849576. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4560 ADMIRALTY WAY STE 101
MARINA DEL REY, CA
ZIP 90292-424
Phone: (310) 577-7544
Fax: (310) 577-5255

The provider's authorized official is Nita Paryus Patel .
The authorized official title is Owner and has the following contact phone number (310) 577-7544.

The CLIA number assigned to this NPI record is 05D0939439 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/11/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207NS0135XDermatologyProcedural DermatologyG076981CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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