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General NPI Number Information
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NPI Number | 1811525124
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Entity Type | Organization
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Legal Business Name | DERMATEX
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 03/31/2020
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Provider Practice Location Address
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Address Line | 23201 MILL CREEK DR STE 225
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-7937
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Country | US
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Telephone | 949-305-2661
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Fax |
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Provider Business Mailing Address
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Address Line | 23201 MILL CREEK DR STE 225
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-7937
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SENO KARAGOZIAN
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Credential |
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Telephone | 949-689-1083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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