Organization
ORISEK AND MCCASKILL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHEL MAXSOM (BUSINESS MANAGER)
(916) 871-5624
Entity
Organization
Contact information
Practice address
4080 CAVITT STALLMAN RD STE 100A, GRANITE BAY, CA 95746-9049
(916) 771-0715
Mailing address
4080 CAVITT STALLMAN RD STE 100A, GRANITE BAY, CA 95746-9049
(916) 771-0715
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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