Organization
EAST COUNTY DERMATOLOGY MEDICAL GROUP INC
Active
Organization
EAST COUNTY DERMATOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JOSEPH THOENE M.D. (PRESIDENT)
(619) 442-4468
Entity
Organization
Contact information
Practice address
514 S MAGNOLIA AVE, EL CAJON, CA 92020-6011
(619) 442-4468
(619) 442-6432
Mailing address
514 S MAGNOLIA AVE, EL CAJON, CA 92020-6011
(619) 442-4468
(619) 442-6432
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G25265
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0017820
—
CA
05
—
GR0017821
—
CA
Enumeration date
07/28/2006
Last updated
06/04/2015
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