Healthcare Provider Details

I. General information

NPI: 1073751129
Provider Name (Legal Business Name): SKIN AND BEAUTY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2009
Last Update Date: 09/02/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 W MAGNOLIA BLVD
BURBANK CA
91505-3034
US

IV. Provider business mailing address

2720 W MAGNOLIA BLVD
BURBANK CA
91505-3034
US

V. Phone/Fax

Practice location:
  • Phone: 818-842-8000
  • Fax: 818-842-3208
Mailing address:
  • Phone: 818-842-8000
  • Fax: 818-842-3208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA73000
License Number StateCA

VIII. Authorized Official

Name: DR. MANJUNATH S VADMAL
Title or Position: PRESIDENT
Credential: MD
Phone: 818-842-8000