RYANRAE SKIN NPI 1578340907

NPI Information

  • NPI: 1578340907
  • Provider Name: RYANRAE SKIN
  • Classification: Allergy & Immunology - 207KA0200X
  • Specialization: Allergy
  • Entity Type: Organization
  • Doing Business As: LAGUNA ALLERGY MEDICAL BOUTIQUE
  • CLIA Number: 05D2303877
  • Address: 2 JOURNEY STE 201
    ALISO VIEJO, CA
    ZIP 92656
  • Phone: (949) 287-4900

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NPI Details

RYANRAE SKIN is an allergy allergy immunology in Aliso Viejo, CA. The provider is a physician who specializes in the diagnosis, treatment, and management of allergies. Source: National Uniform Claim Committee RYANRAE SKIN NPI is 1578340907. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Laguna Allergy Medical Boutique.

The provider's business location address is:

2 JOURNEY STE 201
ALISO VIEJO, CA
ZIP 92656-373
Phone: (949) 287-4900

The provider's authorized official is Gillian Bassirpour .
The authorized official title is Ceo, Cfo and has the following contact phone number (949) 287-4900.

The CLIA number assigned to this NPI record is 05D2303877 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/11/2023 and was last updated on 9/11/2023.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207KA0200XAllergy & ImmunologyAllergyYes

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: 11/21/2025

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