NPI | 1639587066 |
---|---|
Doing Business As | ALTA DERMATOLOGY |
Entity Type | Organization |
Authorized Contact | VICTORIA N. WANG Owner/Principal 949-364-9264 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA 110942) |
Enumeration Date | 2014-07-29 |
Last Update Date | 2014-09-09 |