Individual
DR. JACK S RESNECK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 DIVISADERO ST, 4TH FLOOR DERMATOLOGY FACULTY PRACTICE, SAN FRANCISCO, CA 94143-0316
(415) 353-7800
(415) 353-9654
Mailing address
1635 DIVISADERO ST, STE 625, BOX 1821, SAN FRANCISCO, CA 94143-1821
(415) 476-4029
(415) 476-4150
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A66722
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A667220
PIN
CA
Enumeration date
04/27/2006
Last updated
07/13/2007
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