Organization
DERMATOLOGY & COSMETIC CARE, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN RACKOHN (BUSINESS MANAGER)
(805) 497-8080
Entity
Organization
Contact information
Practice address
425 HAALAND DR., SUITE #204, THOUSAND OAKS, CA 91361
(805) 497-8080
(805) 497-8806
Mailing address
425 HAALAND DR., SUITE # 204, THOUSAND OAKS, CA 91361
(805) 497-8080
(805) 497-8806
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A73488
CA
261QM2500X
Medical Specialty Clinic/Center
Primary
A73488
CA
Other
Enumeration date
01/28/2008
Last updated
04/09/2008
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