Organization
ACLA DERMATOLOGY & MEDICAL CLINIC
Active
Other names
William J. Coffey, Jr.
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA CAMPBELL (OFFICE MANAGER)
(323) 295-0644
Entity
Organization
Contact information
Practice address
3701 STOCKER ST, SUITE 105, LOS ANGELES, CA 90008-5108
(323) 295-0644
(323) 295-3786
Mailing address
PO BOX 48618, 105, LOS ANGELES, CA 90048-0618
(323) 295-0644
(323) 295-3786
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C30645
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C306450
—
CA
Enumeration date
08/30/2007
Last updated
12/07/2011
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