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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