| NPI | 1043315195 |
|---|---|
| Doing Business As | CENTRAL VALLEY DERMATOLOGY MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | BASIL M HANTASH President 408-204-8946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-05-12 |