DOWNEY DERMATOLOGIC MEDICAL GROUP INC NPI 1356425888

NPI Information

DOWNEY DERMATOLOGIC MEDICAL GROUP INC is a specialist in Downey, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DOWNEY DERMATOLOGIC MEDICAL GROUP INC NPI is 1356425888. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11480 BROOKSHIRE AVE STE 109
DOWNEY, CA
ZIP 90241-022
Phone: (562) 869-2478
Fax: (562) 861-1229

The provider's authorized official is Terrence Patrick Greeson .
The authorized official title is President and has the following contact phone number (562) 869-2478.

The CLIA number assigned to this NPI record is 05D0674974 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/24/2006 and was last updated on 10/27/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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