Organization
ADVANCED DERMATOLOGY SURGERY CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE FLORA KARDASHIAN M.D. (PHYSICIAN OWNER)
(559) 435-0337
Entity
Organization
Contact information
Practice address
6769 N FRESNO ST, FRESNO, CA 93710-3715
(559) 435-0337
(559) 435-2918
Mailing address
6769 N FRESNO ST, FRESNO, CA 93710-3715
(559) 435-0337
(559) 435-2918
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
G43958
CA
Other
Enumeration date
03/13/2007
Last updated
05/14/2008
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