| NPI | 1144506833 |
|---|---|
| Doing Business As | WINE COUNTRY DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | BRENT LOFTIS Owner/Physician 707-203-2781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA 20a11845) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2022-07-21 |