Organization
FRED F. SOEPRONO, M.D., INC.
Active
Other names
Advanced Dermatology and Laser Center, Advanced Dermatology & Laser Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONNIE NATHAN DAWOOD MD (PHYSICIAN)
(949) 367-1115
Entity
Organization
Contact information
Practice address
255 TERRACINA BLVD, SUITE 206, REDLANDS, CA 92373-4870
(909) 792-8600
(909) 792-8660
Mailing address
255 TERRACINA BLVD STE 206, REDLANDS, CA 92373-4870
(909) 792-8600
(909) 792-8660
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
CA
Other
Enumeration date
05/29/2007
Last updated
12/07/2021
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