LA LASER CENTER, PC, A PROFESSIONAL MEDICAL CORPORATION


Address: 161 Avenida Vaquero, San Clemente, CA 92672-3601
Phone: 9496523095

LA LASER CENTER, PC, A PROFESSIONAL MEDICAL CORPORATION (NPI# 1306982855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306982855
Entity Type Organization
Organization Name LA LASER CENTER, PC, A PROFESSIONAL MEDICAL CORPORATION
Practice Address 161 Avenida Vaquero
San Clemente
CA 92672-3601
Mailing Address Po Box 16297
Beverly Hills
CA 90209-2297
Practice Telephone 9496523095
Mailing Telephone 4242764700
Enumeration Date 2007-01-30
Last Update Date 2020-05-18
Authorized Official Name DR. DANIEL TAHERI (OWNER)
Authorized Official Telephone 3109221412
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207N00000X Dermatology Allopathic & Osteopathic Physicians
N 207ND0101X Dermatology
Specialization: MOHS-Micrographic Surgery
Allopathic & Osteopathic Physicians
Y 261QM2500X Clinic/Center
Specialization: Medical Specialty
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
AZ 247778 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
1840 Mesquite Ave Ste G102, Lake Havasu City, AZ 864035771 9287198400 9287198402

Office Location

Street Address 161 AVENIDA VAQUERO
City SAN CLEMENTE
State CA
Zip Code 92672-3601

Providers in the same location

NPI Name Taxonomy Address Enumeration
1255431219 Pacific Sleep Labs, Inc. Clinic/Center 161 Avenida Vaquero, San Clemente, CA 92672-3601 2006-09-22
1992032122 Shorecliffs Medical Group Inc Internal Medicine 161 Avenida Vaquero, San Clemente, CA 92672-3601 2009-11-09

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NPI Name Taxonomy Address Enumeration
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Taxonomy Information

Taxonomy Code 261QM2500X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Medical Specialty

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1235432493 Edward H Bestard M D Inc Clinic/Center 653 Camino De Los Mares, 102, San Clemente, CA 92673-2808 2010-12-09

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Competitor

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City SAN CLEMENTE
Zip Code 92672

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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