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Organization
ADVANCED DERMATOLOGY SURGERY CENTER, INC
Active
Organization
ADVANCED DERMATOLOGY SURGERY CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE FLORA KARDASHIAN M.D. (PHYSICIAN OWNER)
(559) 435-0337
Entity
Organization
Contact information
Practice address
6769 N FRESNO ST, FRESNO, CA 93710-3715
(559) 435-0337
(559) 435-2918
Mailing address
6769 N FRESNO ST, FRESNO, CA 93710-3715
(559) 435-0337
(559) 435-2918
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
G43958
CA
Other
Enumeration date
03/13/2007
Last updated
05/14/2008
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