Organization
PENINSULA DERMATOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD M KAY M.D. (PRESIDENT)
(650) 692-0182
Entity
Organization
Contact information
Practice address
1750 EL CAMINO REAL, STE 206, BURLINGAME, CA 94010
(650) 692-0182
(650) 692-7741
Mailing address
1750 EL CAMINO REAL, STE 206, BURLINGAME, CA 94010
(650) 692-0182
(650) 692-7741
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ20101Z
MEDICARE PROVIDER NUMBER
CA
Enumeration date
10/24/2006
Last updated
10/27/2014
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