Organization
ADVANCED DERMATOLOGY INC.
Active
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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