Individual
ALLISON LACEY MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3254 PROFESSIONAL DR, AUBURN, CA 95602-2412
(530) 888-1016
(530) 888-1346
Mailing address
300 SIERRA COLLEGE DR, SUITE 235, GRASS VALLEY, CA 95945-5082
(530) 273-6530
(530) 273-3951
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A71954
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0100570
—
CA
Enumeration date
10/31/2006
Last updated
09/13/2008
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