ELEGANT SKIN CARE MEDICAL CENTER, INC. (NPI# 1598772337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598772337 |
| Entity Type | Organization |
| Organization Name | ELEGANT SKIN CARE MEDICAL CENTER, INC. |
| Practice Address |
1117 N Hollywood Way B Burbank CA 91505-2528 |
| Practice Telephone | 8189559550 |
| Practice Fax Number | 8189559507 |
| Mailing Telephone | 8189559550 |
| Mailing Fax Number | 8189559507 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ALBERT M KELLY (OWNER/CEO) |
| Authorized Official Telephone | 8189559550 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 20A8453 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CERTIFICATE | 20A8453 | 01 |
| Street Address |
1117 N HOLLYWOOD WAY B |
| City | BURBANK |
| State | CA |
| Zip Code | 91505-2528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922406248 | San Bernardino Home Healthcare, Inc | Home Health | 1117 N Hollywood Way, Burbank, CA 91505-2528 | 2014-12-18 |
| 1174950505 | Good Choice Home Health, Inc. | Home Health | 1117 N Hollywood Way, Suite B, Burbank, CA 91505-2528 | 2013-09-30 |
| 1730492240 | Pronto Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 1117 N Hollywood Way, Burbank, CA 91505-2528 | 2010-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023625035 | K and S Hospice Inc | Hospice Care, Community Based | 4100 W Alameda Ave Fl 3, Burbank, CA 91505 | 2020-09-24 |
| 1013542471 | Jami Stehlin | Nurse Practitioner | 501 S. Buena Vista St. 3ne, Burbank, CA 91505 | 2020-03-06 |
| 1497309033 | Ibrahim Lala | Pharmacist | 181 S. Buena Vista St, Burbank, CA 91505 | 2019-08-01 |
| 1720501240 | Jung H Li | Registered Nurse | Psjmc- Bariatric Wellness Center, 501 S Buena Vista St, Burbank, CA 91505 | 2017-07-18 |
| 1699204974 | Beth Ellen Izbotsky | Physical Medicine & Rehabilitation | 501 S Buena Vista Blvd, Burbank, CA 91505 | 2017-06-08 |
| 1205387446 | Fabiola Bachman | Dentist | 138 N Pass Ave, 2, Burbank, CA 91505 | 2016-10-24 |
| 1114478203 | Marianna Ghularyan D.d.s. Inc | Dentist | 1400 N. Edison Blvd., Burbank, CA 91505 | 2016-10-24 |
| 1962952127 | Landa Mizin Dental Partnership | Dentist | 2625 W Alameda Ave Ste 502, Burbank, CA 91505 | 2016-10-11 |
| 1285183376 | Amy Di Francia | Marriage & Family Therapist | 4421 W Riverside Dr Ste 210, Burbank, CA 91505 | 2016-09-29 |
| 1306238381 | Abigail Merrin | Physical Therapist | 2701 W Alameda Ave Ste 206, Burbank, CA 91505 | 2015-02-26 |
| Find all providers in zip 91505 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346751849 | Mcs Medical Group Inc | General Practice | 348 E Olive Sve, Suite B1, Burbank, CA 91502-1235 | 2017-10-24 |
| 1356415814 | Eugenia Davis | General Practice | 3703 W Burbank Blvd, Burbank, CA 91505-2240 | 2006-11-17 |
| 1750308235 | Kusum Rudrappa | General Practice | 421 E Angeleno Ave, Ste: 206b, Burbank, CA 91501-2286 | 2006-07-17 |
| 1538146840 | Samir Ak Nazo | General Practice | 2307 W Empire Ave, Burbank, CA 91504-3318 | 2005-12-28 |
| 1306253687 | Pacific Accountable Care Network Inc | General Practice | 201 S Buena Vista St, Suite 425, Burbank, CA 91505-4569 | 2014-07-17 |
| 1285948927 | Aguiluz Medical Corporation, Inc | General Practice | 10970 Sherman Way, Burbank, CA 91505-1002 | 2010-08-05 |
| 1205077039 | Olive Health Medical Group Inc | General Practice | 500 E Olive Ave, Suite 315, Burbank, CA 91501-3316 | 2009-03-06 |
| 1124288360 | Dyan M. Cole Md, Inc | General Practice | 401 S Glenoaks Blvd, Ste. # 203b, Burbank, CA 91502-1448 | 2008-06-11 |
| 1992981161 | Philip H Lee | General Practice | 421 E Angeleno Ave Ste 102, Burbank, CA 91501-2286 | 2008-01-17 |
| 1821273517 | Paula J. Schoen | General Practice | 3808 W Riverside Dr, Suite 200, Burbank, CA 91505-4325 | 2008-01-01 |
| Find all providers in BURBANK | ||||
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| 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.