Healthcare Provider Details

I. General information

NPI: 1104665744
Provider Name (Legal Business Name): BATAL LASER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2024
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 2ND ST STE 100
SANTA MONICA CA
90401-2323
US

IV. Provider business mailing address

1423 2ND ST STE 100
SANTA MONICA CA
90401-2323
US

V. Phone/Fax

Practice location:
  • Phone: 310-714-8896
  • Fax: 310-388-1193
Mailing address:
  • Phone: 310-714-8896
  • Fax: 310-388-1193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. OBAIDA BATAL
Title or Position: MEDICAL DIRECTOR/PRESIDENT
Credential: MD
Phone: 310-714-8896