| NPI | 1952319964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C STEPHEN GOETZ Medical Doctor Owner 916-966-6444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology Dermatopathology (Licence: CA 632226) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA 632226) |
| 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: CA 632226) | |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: CA 632226) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: CA 632226) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2008-03-06 |