Organization
DERMATOLOGY SPECIALISTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE LISK (ADMINISTRATOR)
(760) 757-7546
Entity
Organization
Contact information
Practice address
31469 RANCHO PUEBLO RD # 101, TEMECULA, CA 92592-4834
(951) 304-7546
Mailing address
3629 VISTA WAY, OCEANSIDE, CA 92056-4522
(760) 828-9128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA14750
CA
Other
Enumeration date
01/19/2016
Last updated
01/19/2016
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