Organization
BOSTON DERMATOLOGY CORPORATION
Active
Organization
BOSTON DERMATOLOGY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAEED NAWAZ JAFFER M.D. (PRESIDENT)
(626) 653-2525
Entity
Organization
Contact information
Practice address
262 W BADILLO ST, COVINA, CA 91723-1906
(626) 653-2525
(626) 653-0808
Mailing address
262 W BADILLO ST, COVINA, CA 91723-1906
(626) 653-2525
(626) 653-0808
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A74086
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A74086
CA
207ND0900X
Dermatopathology Physician
A74086
CA
207NP0225X
Pediatric Dermatology Physician
A74086
CA
207NS0135X
Procedural Dermatology Physician
A74086
CA
Other
Enumeration date
09/14/2007
Last updated
10/05/2020
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