Organization
ADVANCED SKIN INSTITUTE, INC.
Active
Other names
Advanced Skin Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASIL M HANTASH MD, PHD (PRESIDENT)
(408) 204-8946
Entity
Organization
Contact information
Practice address
3800 GEER RD STE 200, TURLOCK, CA 95382-1146
(209) 668-3063
(209) 668-4992
Mailing address
3800 GEER RD STE 200, TURLOCK, CA 95382-1146
(209) 668-3063
(209) 668-4992
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Enumeration date
12/22/2010
Last updated
05/12/2020
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