Individual
DR. MIRA STOTLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
267 W HILLCREST DR, THOUSAND OAKS, CA 91360-4211
(805) 497-1694
(805) 373-7493
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A118635
CA
Other
Enumeration date
06/27/2007
Last updated
06/20/2025
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