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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