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General NPI Number Information
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NPI Number | 1679029029
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Entity Type | Organization
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Legal Business Name | NEW SKIN UVB LIGHT THERAPY
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Dates
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Enumeration Date | 08/26/2016
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Last Update Date | 08/26/2016
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Provider Practice Location Address
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Address Line | 9042 GARFIELD AVE STE 206
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-2340
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Country | US
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Telephone | 714-388-8817
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Fax |
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Provider Business Mailing Address
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Address Line | 9042 GARFIELD AVE STE 206
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-2340
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Country | US
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Telephone | 714-388-8817
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. DANA COLE
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Credential | DC
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Telephone | 714-388-8817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 68972
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License Number State | CA
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