Active NPI
Vitalskin Clinic
- Clinic/Center
- Valley Village, CA
National Provider Identifier
1750290730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- VITALSKIN CLINIC
- Practice address
- 5301 Laurel Canyon Blvd Ste 116
Valley Village, CA 91607-2763 - Phone
- (949) 628-4115
- NPI assigned
- Sep 4, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nattapong Lertwanarin
- Title
- Ceo
- Phone
- (949) 628-4115
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
5301 Laurel Canyon Blvd Ste 116
Valley Village, CA 91607-2763
Mailing address
5301 Laurel Canyon Blvd Ste 116
Valley Village, CA 91607-2763
Phone (949) 628-4115
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788480000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788480000000",
"number": "1750290730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5301 LAUREL CANYON BLVD STE 116",
"city": "VALLEY VILLAGE",
"state": "CA",
"postal_code": "916072763",
"telephone_number": "949-628-4115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 LAUREL CANYON BLVD STE 116",
"city": "VALLEY VILLAGE",
"state": "CA",
"postal_code": "916072763",
"telephone_number": "949-628-4115"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VITALSKIN CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-04",
"last_updated": "2026-09-04",
"certification_date": "2026-09-04",
"status": "A",
"authorized_official_last_name": "LERTWANARIN",
"authorized_official_first_name": "NATTAPONG",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "949-628-4115"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Village, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.