| NPI | 1366093999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY-ANNE CLARKE Practice Administrator 530-342-3686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-25 |