Organization
SOUTH BAY SKIN & CANCER MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER PAUL RULLAN M.D. (MEDICAL DIRECTOR)
(619) 426-9600
Entity
Organization
Contact information
Practice address
256 LANDIS AVE, THIRD FLOOR, CHULA VISTA, CA 91910-2650
(619) 426-9600
(619) 426-4112
Mailing address
256 LANDIS AVE, THIRD FLOOR, CHULA VISTA, CA 91910-2650
(619) 426-9600
(619) 426-4112
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
G42243
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ73699Z
—
CA
Enumeration date
11/09/2006
Last updated
03/14/2022
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