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Organization

PALMDALE DERMATOLOGY AND SKIN CANCER PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL TAHERI MD (PRESIDENT)
(661) 947-9000
Entity
Organization

Contact information

Practice address
631 W AVENUE Q, SUITE B, PALMDALE, CA 93551-3892
(661) 947-9000
(661) 266-8751
Mailing address
PO BOX 496084, REDDING, CA 96049-6084
(661) 947-9000

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
FNP42964
FNP
CA
Enumeration date
06/29/2012
Last updated
06/29/2012
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