Organization
DERMESURGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM ABAZA MD (CEO)
(909) 860-4254
Entity
Organization
Contact information
Practice address
1111 GRAND AVE STE K, DIAMOND BAR, CA 91765-4172
(909) 860-4254
(098) 602-6749
Mailing address
1111 GRAND AVE STE K, DIAMOND BAR, CA 91765-4172
(909) 860-4254
(098) 602-6749
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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