Organization
MAVEN DERMATOLOGY APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSLEEN AHLUWALIA MD (CEO)
(858) 736-9900
Entity
Organization
Contact information
Practice address
3750 CONVOY ST STE 155, SAN DIEGO, CA 92111-3739
(858) 736-9900
(858) 736-0661
Mailing address
3750 CONVOY ST STE 155, SAN DIEGO, CA 92111-3739
(858) 736-9900
(858) 736-0661
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A144826
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
08/07/2023
Last updated
11/05/2025
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