The Family Skin Therapy Center at on the Beach, Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

THE FAMILY SKIN THERAPY CENTER AT ON THE BEACH, INC.

Practice address

10660 Riverside Dr
Unit D
Toluca Lake, CA 91602-2352

Phone

(818) 766-4247

Fax

(818) 506-1259

NPI assigned

Jul 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gino Morrow

Title

Administrator

Phone

(818) 766-4247

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881619500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10660 RIVERSIDE DR",
            "address_2": "UNIT D",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022352",
            "telephone_number": "818-766-4247",
            "fax_number": "818-506-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10660 RIVERSIDE DR",
            "address_2": "UNIT D",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022352",
            "telephone_number": "818-766-4247",
            "fax_number": "818-506-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY SKIN THERAPY CENTER AT ON THE BEACH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORROW",
        "authorized_official_first_name": "GINO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-766-4247",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Toluca Lake, CA
• Providers in Toluca Lake, CA by specialty
• Dermatology 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.