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Organization

SOLANO DERMATOLOGY ASSOCIATES INC

Active
Parent organization
SOLANO DERMATOLOGY ASSOCIATES INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOLANO DERMATOLOGY ASSOCIATES INC
Authorized official
DR. JOHN KEVIN GEISSE M.D. (OWNER)
(707) 643-5785
Entity
Organization

Contact information

Practice address
480 CHADBOURNE RD, STE 201, FAIRFIELD, CA 94534-9647
(707) 643-5785
(707) 643-5876
Mailing address
2290 SACRAMENTO ST, VALLEJO, CA 94590-2929
(707) 643-5785
(707) 643-5876

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0023150
CA
Enumeration date
01/25/2009
Last updated
01/25/2009
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