Individual
SAMANTHA ROSE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 SAN RAMON VALLEY BLVD STE 102, DANVILLE, CA 94526-4021
(925) 838-4900
(925) 838-4920
Mailing address
3301 C ST, SUITE 1400, SACRAMENTO, CA 95816-3300
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A144841
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2015
Last updated
04/18/2019
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