OMNI DERMATOLOGY OLIVE LLC is a specialist in Glendale, AZ. 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. OMNI DERMATOLOGY OLIVE LLC NPI is 1669914172. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
5700 W OLIVE AVE
STE 101
GLENDALE, AZ
ZIP 85302-147
Phone: (602) 559-5470
Fax: (602) 559-5471
The provider's authorized official is Andrew Joseph Racette .
The authorized official title is President and has the following contact phone number (602) 954-3919.
The CLIA number assigned to this NPI record is 03D2092598 - physician office with a certificate type of Certificate of Compliance.
The enumeration date for this NPI number is 11/15/2016 and was last updated on 11/15/2016.