Organization
ADVANCED DERMATOLOGY INC.
Active
Other names
Advanced Dermatology of San Clemente Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARYAM MOINFAR MD (PRESIDENT)
(952) 240-2827
Entity
Organization
Contact information
Practice address
34213 PACIFIC COAST HWY, DANA POINT, CA 92629
(949) 248-4547
(949) 248-4587
Mailing address
34213 PACIFIC COAST HWY, DANA POINT, CA 92629-2875
(952) 240-2827
(949) 248-4587
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A92449
CA
Other
Enumeration date
10/17/2006
Last updated
06/27/2019
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