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
25495 MEDICAL CENTER DRIVE, #200, MURRIETA, CA 92562
(951) 304-7546
Mailing address
3629 VISTA WAY, OCEANSIDE, CA 92056
(760) 757-7546
(760) 828-9138
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881631711
GROUP NPI
CT
05
—
GR0029464
—
CA
Enumeration date
07/27/2007
Last updated
01/27/2015
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