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Organization

MIREMADI DERMATOLOGY MEDICAL CORPORATION

Active
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Organization

MIREMADI DERMATOLOGY MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ARJANG K MIREMADI M.D. (PHYSICIAN/OWNER)
(858) 456-1840
Entity
Organization

Contact information

Practice address
7702 IVANHOE AVE, LA JOLLA, CA 92037-4520
(858) 456-1840
Mailing address
7702 IVANHOE AVE, LA JOLLA, CA 92037-4520
(858) 456-1840

Taxonomy

Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
A31016
CA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
A31016
CA
207NP0225X
Pediatric Dermatology Physician
A31016
CA
207NS0135X
Procedural Dermatology Physician
A31016
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A310160
CA
Enumeration date
11/14/2007
Last updated
12/20/2007
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