Healthcare Provider Details

I. General information

NPI: 1437901931
Provider Name (Legal Business Name): ENCINO LASER AND SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28049 SMYTH DR
VALENCIA CA
91355-4023
US

IV. Provider business mailing address

28049 SMYTH DR
VALENCIA CA
91355-4023
US

V. Phone/Fax

Practice location:
  • Phone: 818-906-6900
  • Fax:
Mailing address:
  • Phone: 818-906-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL T LIN
Title or Position: CEO/OWNER
Credential: MD
Phone: 818-906-6900