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Organization

ROSEVILLE DERMATOLOGY INC.

Active
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Organization

ROSEVILLE DERMATOLOGY INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER H HA M.D. (PRESIDENT)
(916) 784-7546
Entity
Organization

Contact information

Practice address
1211 PLEASANT GROVE BLVD, SUITE 100, ROSEVILLE, CA 95678-6971
(916) 784-7546
(916) 784-7548
Mailing address
1211 PLEASANT GROVE BLVD, SUITE 100, ROSEVILLE, CA 95678-6971
(916) 784-7546
(916) 784-7548

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A604281
BLUE CROSS PIN
CA
01
1898591
CIGNA PIN
CA
Enumeration date
06/01/2006
Last updated
11/09/2007
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