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

Advance Dermatology & Laser Medical Center Inc

Organization Procedural Dermatology Physician · NPI 1396849576

Advance Dermatology & Laser Medical Center Inc is a Procedural Dermatology Physician in Marina del Rey, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4560 Admiralty Way Ste 101
Marina del Rey, CA 90292-5424
Phone: (310) 577-7544
Fax: (310) 577-5255
Show map & directions

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

Specialties & licences

Procedural Dermatology Physician (primary) Taxonomy 207NS0135X · Licence G076981 (CA)

Record details

NPI number1396849576
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nita Patel — Owner · (310) 577-7544
NPI enumeratedSeptember 11, 2006
Last updated in NPPESDecember 16, 2022
Certification dateDecember 16, 2022
Mailing address4560 Admiralty Way Ste 101, Marina Del Rey, CA 90292-5424