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General NPI Number Information
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NPI Number | 1659221281
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Entity Type | Organization
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Legal Business Name | ENHANCED DERMATOLOGY OF ORANGE COUNTY
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 17601 17TH ST STE 110
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City | TUSTIN
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State | CA
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Zip | 92780-1949
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Country | US
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Telephone | 714-790-0005
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Fax | 714-699-2444
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Provider Business Mailing Address
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Address Line | 17601 17TH ST STE 110
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City | TUSTIN
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State | CA
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Zip | 92780-1949
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Country | US
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Telephone | 714-790-0005
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Fax | 714-699-2444
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Authorized Official
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Title or Position | BILLER
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Name | LISA LEFEVRE
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Credential |
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Telephone | 657-331-1901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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