Organization
AESTHETIC DERMATOLOGY & COSMETIC SURGERY MEDICAL ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE LANOUE (REMOTE BUSINESS SUPERVISOR)
(605) 484-7519
Entity
Organization
Contact information
Practice address
535 MILLER AVE, MILL VALLEY, CA 94941-2905
(415) 383-5486
(415) 389-7455
Mailing address
535 MILLER AVE, MILL VALLEY, CA 94941-2905
(415) 383-5486
(415) 389-7455
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
CA
Other
Enumeration date
08/26/2005
Last updated
12/16/2022
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