AESTHETIC SURGERY & LASER MEDICAL CENTER INC NPI 1467572115

NPI Information

AESTHETIC SURGERY & LASER MEDICAL CENTER INC is an ambulatory surgical clinic center in Valencia, CA. AESTHETIC SURGERY & LASER MEDICAL CENTER INC NPI is 1467572115. The provider is registered as an organization entity type.

The provider's business location address is:

28212 KELLY JOHNSON PKWY
SUITE 265
VALENCIA, CA
ZIP 91355-084
Phone: (661) 254-3686
Fax: (661) 254-5671

The provider's authorized official is Bernard I Raskin .
The authorized official title is Medical Director and has the following contact phone number (661) 254-3686.

The CLIA number assigned to this NPI record is 05D2031108 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/29/2007 and was last updated on 7/16/2015.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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