| NPI | 1154527901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE SMITH Practice Manager 650-969-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G81771) |
| Additional Taxonomies | 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: CA G81771) |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: CA G81771) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: CA G81771) | |
| 207ND0900X Dermatology Dermatopathology (Licence: CA G81771) | |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: CA G81771) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2007-12-26 |