Organization
AFFILIATED DERMATOLOGISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD A SEARLE MD (PHYSICIAN /PRESIDENT)
(805) 484-3331
Entity
Organization
Contact information
Practice address
3901 LAS POSAS RD, SUITE 108, CAMARILLO, CA 93010
(805) 484-3331
(805) 987-2118
Mailing address
3901 LAS POSAS RD, SUITE 108, CAMARILLO, CA 93010
(805) 484-3331
(805) 987-2118
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G079257
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OOG297660
—
CA
01
—
ZZZ54249Z
BLUE SHIELD
—
Enumeration date
06/07/2006
Last updated
01/25/2011
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