Individual
ROLAND HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2545 W HAMMER LN, STOCKTON, CA 95209-2839
(209) 957-7050
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
C34191
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C341910
—
CA
Enumeration date
05/09/2006
Last updated
07/14/2010
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