Organization
SUBLIME MD, A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
SUBLIME MD, A PROFESSIONAL MEDICAL CORPORATION
Active
Other names
Sublime MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONNIE NATHAN DAWOOD MD (PRESIDENT)
(949) 367-1115
Entity
Organization
Contact information
Practice address
255 TERRACINA BLVD STE 206, REDLANDS, CA 92373-4870
(909) 792-8600
Mailing address
7095 INDIANA AVE STE 210, RIVERSIDE, CA 92506-4159
(951) 218-9910
(888) 561-4883
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/05/2021
Last updated
01/27/2022
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