Elegant Skin Care Medical Center, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

20A8453 Issued in CA

Legal business name

ELEGANT SKIN CARE MEDICAL CENTER, INC.

Practice address

1117 N Hollywood Way
B
Burbank, CA 91505-2528

Phone

(818) 955-9550

Fax

(818) 955-9507

NPI assigned

Aug 2, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Albert M Kelly, D.O.NPI 1730197955

Title

Owner/Ceo

Phone

(818) 955-9550

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Albert M Kelly, DO

  • Anesthesiology Physician
  • Rancho Mirage, CA
  • NPI 1730197955
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598772337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 N HOLLYWOOD WAY",
            "address_2": "B",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052528",
            "telephone_number": "818-955-9550",
            "fax_number": "818-955-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 N HOLLYWOOD WAY",
            "address_2": "B",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052528",
            "telephone_number": "818-955-9550",
            "fax_number": "818-955-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEGANT SKIN CARE MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "818-955-9550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A8453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATE",
            "identifier": "20A8453",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Elahian
• Amanda Nabil Eldabh, LCSW
• Emily Christine Eldred, PA
• Electroease, Inc (Electropedic)
• Elegance Home Health Inc
• Martina Emilova Elenkova, DDS, MDS
• Sriram Venkata Eleswarapu, M.D., PH.D.
• Elevate Wound Care
• Eli Ahdoot, DO, Inc.
• Elie Dental Corporation (Empire Dental Group)

• General Practice Physician in Burbank, CA
• Providers in Burbank, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.