| NPI | 1407950785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH ANN LARSON President 858-451-3311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G41388) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G41388) |
| 207ND0900X Dermatology, Dermatopathology (Licence: CA G49647) | |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2007-11-06 |