Organization
EITAN HOMA MD AND JENNIFER KRASNOFF MD INC
Active
Other names
Dermatology Associates of the Bay Area
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARLENE KOLE (OFFICE MANAGER)
(510) 741-7418
Entity
Organization
Contact information
Practice address
500 ALFRED NOBEL DR, STE 245, HERCULES, CA 94547
(510) 741-7418
(510) 741-7456
Mailing address
500 ALFRED NOBEL DR, STE 245, HERCULES, CA 94547
(510) 741-7418
(510) 741-7456
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C14303
RAILROAD MEDICARE
CA
01
—
ZZZ00647Z
BLUE SHILED
CA
Enumeration date
09/29/2006
Last updated
05/06/2008
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