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General NPI Number Information
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NPI Number | 1861787673
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Entity Type | Organization
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Legal Business Name | JOHN CHRISTIAN LAYKE DO
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 06/09/2011
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Provider Practice Location Address
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Address Line | 436 N BEDFORD DR SUITE 308
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4310
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Country | US
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Telephone | 310-275-6600
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Fax | 310-275-6607
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Provider Business Mailing Address
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Address Line | 436 N BEDFORD DR SUITE 308
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4310
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Country | US
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Telephone | 310-275-6600
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Fax | 310-275-6607
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Authorized Official
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Title or Position | CEO
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Name | JOHN CHRISTIAN LAYKE
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Credential | DO
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Telephone | 310-275-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 20A10771
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License Number State | CA
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