Organization
SUNRISE DERMATOLOGY PC
Active
Organization
SUNRISE DERMATOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID OTHMAN (CEO)
(818) 639-2339
Entity
Organization
Contact information
Practice address
3095 OLD CONEJO RD STE 300, THOUSAND OAKS, CA 91320-2130
(805) 864-2920
Mailing address
3095 OLD CONEJO RD STE 300, THOUSAND OAKS, CA 91320-2130
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
05/22/2024
Last updated
05/30/2024
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