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General NPI Number Information
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NPI Number | 1083520407
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Entity Type | Organization
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Legal Business Name | LA LASER CENTER PC, A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 862 MEINECKE AVE STE 200
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-3704
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Country | US
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Telephone | 805-250-1080
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16297
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City | BEVERLY HILLS
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State | CA
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Zip | 90209-2297
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Country | US
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Telephone | 888-993-3761
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DANIEL TAHERI
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Credential |
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Telephone | 310-922-1412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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