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Individual

DR. VINCE FERHAD AFSAHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2552 WALNUT AVE, SUITE 120, TUSTIN, CA 92780-6935
(714) 508-0754
(174) 508-5754
Mailing address
2552 WALNUT AVE, SUITE 120, TUSTIN, CA 92780-6935
(714) 508-0754
(174) 508-5754

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A67614
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A67614
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1033241138
SOUTH COAST DERMATOLOGY NPI
CA
Enumeration date
08/11/2005
Last updated
03/07/2013
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