Organization
ICECREAMWALA DERMATOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVIKA ICECREAMWALA MD (AUTHORIZED OFFICIAL)
(510) 646-8070
Entity
Organization
Contact information
Practice address
2435 WEBSTER ST STE 101, BERKELEY, CA 94705
(510) 646-8070
(833) 484-7048
Mailing address
2435 WEBSTER ST STE 101, BERKELEY, CA 94705-2050
(510) 646-8070
(833) 484-7048
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
CA
207NP0225X
Pediatric Dermatology Physician
—
CA
Other
Enumeration date
06/27/2018
Last updated
07/02/2018
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