Organization
DELTA DERMATOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARLENE D SAMPSON MD (SOLE PROPRIETOR)
(310) 673-3582
Entity
Organization
Contact information
Practice address
310 N PRAIRIE AVE, SUITE 412, INGLEWOOD, CA 90301
(310) 673-3582
(310) 677-5466
Mailing address
310 N PRAIRIE AVE, SUITE 412, INGLEWOOD, CA 90301
(310) 673-3582
(310) 677-5466
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G49164
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G491641
—
CA
Enumeration date
01/02/2007
Last updated
08/06/2008
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