Organization
WEST OAK DERMATOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN BOYSE GANT MD (OWNER)
(916) 755-0077
Entity
Organization
Contact information
Practice address
258 GIBSON DR, STE 140, ROSEVILLE, CA 95678-5881
(916) 755-0077
(916) 755-0099
Mailing address
258 GIBSON DR, STE 140, ROSEVILLE, CA 95678-5881
(916) 755-0077
(916) 755-0099
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
123615
CA
Other
Enumeration date
10/23/2017
Last updated
08/13/2018
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