Provider Demographics
NPI:1669206462
Name:SKIN SAVVY MEDICAL GROUP INC.
Entity type:Organization
Organization Name:SKIN SAVVY MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:BREE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-630-6124
Mailing Address - Street 1:860 HAMPSHIRE RD STE I
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-6019
Mailing Address - Country:US
Mailing Address - Phone:805-630-6124
Mailing Address - Fax:
Practice Address - Street 1:49 PIER AVE STE 2A
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-3776
Practice Address - Country:US
Practice Address - Phone:310-561-5030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty