Organization
MEDDERM CORPORATION
Active
Other names
Medderm Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE TEREZ PELLE M.D. (OWNER/DIRECTOR)
(619) 542-0013
Entity
Organization
Contact information
Practice address
3965 5TH AVE STE 200, SAN DIEGO, CA 92103-3107
(619) 542-0013
(619) 542-0559
Mailing address
3965 5TH AVE STE 200, SAN DIEGO, CA 92103-3107
(619) 542-0013
(619) 542-0559
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A88009
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A880090
—
CA
Enumeration date
07/11/2006
Last updated
04/18/2023
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