OrganizationActive
Advance Dermatology & Laser Medical Center Inc.
NPI 1396849576 · Procedural Dermatology Physician · Marina Del Rey, CA
Provider details
- NPI number
- 1396849576
- Entity type
- Organization
- Primary specialty
- Procedural Dermatology PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Nita Patel, Owner
- License
- G076981 (CA)
Practice location
4560 Admiralty Way Ste 101
Marina Del Rey, CA 90292-5424
Phone: (310) 577-7544
Fax: (310) 577-5255
Mailing address
4560 Admiralty Way Ste 101
Marina Del Rey, CA 90292-5424
Registry dates
- Enumerated
- 2006-09-11
- Last updated
- 2022-12-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.