Organization
DERMATOLOGIC PLASTIC SURGERY CLINICS OF CA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL STEPHEN COLLINS M.D. (PRESIDENT)
(805) 543-5052
Entity
Organization
Contact information
Practice address
84 SANTA ROSA ST, SAN LUIS OBISPO, CA 93405-1812
(806) 543-5052
(805) 543-1639
Mailing address
84 SANTA ROSA ST, SAN LUIS OBISPO, CA 93405-1812
(806) 543-5052
(805) 543-1639
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C42368
CA
Other
Enumeration date
03/17/2007
Last updated
08/22/2020
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