| NPI | 1336220540 |
|---|---|
| Doing Business As | ADVANCED DERMATOLOGY OF SAN CLEMENTE INC |
| Entity Type | Organization |
| Authorized Contact | MARYAM MOINFAR President 952-240-2827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A92449) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2019-06-27 |