Organization
INTEGRATED DERMATOLOGY OF ENCINITAS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY D QUEEN (MANAGER)
(561) 314-2000
Entity
Organization
Contact information
Practice address
320 SANTA FE DR, SUITE 310, ENCINITAS, CA 92024-5138
(760) 944-7000
Mailing address
902 CLINT MOORE RD, SUITE 226, BOCA RATON, FL 33487-2800
(561) 314-2000
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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