Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Socal Skin and Surgery

Organization Dermatology Physician · NPI 1710687157

Socal Skin and Surgery provides Dermatology Physician services in Los Angeles, California. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

12555 W Jefferson Blvd Ste 202
Los Angeles, CA 90066-7047
Phone: (424) 543-0066
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1710687157
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jenny Wang — Dermatologist · (240) 246-3164
Other names Socal Skin And Surgery; Socal Skin And Surgery
NPI enumeratedMarch 6, 2023
Last updated in NPPESJuly 4, 2023
Certification dateJuly 4, 2023
Mailing address12555 W Jefferson Blvd Ste 202, Los Angeles, CA 90066-7047

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