Provider profile · NPI 1396849576

Advance Dermatology & Laser Medical Center Inc.

Dermatology, Procedural Dermatology · Marina Del Rey, CA · NPI 1396849576 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Dermatology, Procedural Dermatology

Enumerated

Sep 11, 2006

License(s)

G076981 (CA)

Addresses on file

PurposeAddressCity/StatePhone
LOCATION4560 ADMIRALTY WAY STE 101 Marina Del Rey, CA 90292-5424310-577-7544
MAILING4560 ADMIRALTY WAY STE 101 Marina Del Rey, CA 90292-5424310-577-7544

View on NPPES registry ↗

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