NPI | 1255752796 |
---|---|
Entity Type | Organization |
Authorized Contact | ANI L TAJIRIAN Owner/President 510-839-2937 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA A119900) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A119900) |
207NS0135X Dermatology, Procedural Dermatology (Licence: CA A119900) | |
Enumeration Date | 2013-12-31 |
Last Update Date | 2013-12-31 |