Organization
CHACON BNK PC
Active
Other names
Rocklin Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
SIDDHARTH SHAH (AUTHORIZED OFFICIAL)
(770) 864-2620
Entity
Organization
Contact information
Practice address
2203 PLAZA DR STE 110, ROCKLIN, CA 95765-4427
(916) 938-2531
Mailing address
2203 PLAZA DR STE 110, ROCKLIN, CA 95765-4427
(916) 938-2531
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
04/19/2024
Last updated
09/19/2024
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