Organization
LAKESIDE DERMATOLOGY - A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE NGOC DO DO (PRESIDENT)
(415) 317-7261
Entity
Organization
Contact information
Practice address
1 SHRADER STREET, #640, SAN FRANCISCO, CA 94117
(415) 422-0000
(415) 424-4140
Mailing address
1 SHRADER STREET, #640, SAN FRANCISCO, CA 94117
(415) 422-0000
(415) 424-4140
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20A9018
CA
Other
Enumeration date
08/05/2011
Last updated
10/06/2020
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