Organization
DESCANSO DERMATOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A HONCH M.D. (PARTNER)
(818) 790-6726
Entity
Organization
Contact information
Practice address
1346 FOOTHILL BLVD, STE 203, LA CANADA, CA 91011-2141
(818) 790-6726
(818) 790-9562
Mailing address
1346 FOOTHILL BLVD, STE 203, LA CANADA, CA 91011-2141
(818) 790-6726
(818) 790-9562
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
G40665
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0082860
—
CA
01
—
ZZZ157442
BLUE SHIELD
—
Enumeration date
06/01/2005
Last updated
03/26/2008
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