Organization
DERMATOLOGY SPECIALISTS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE LISK (ADMINISTRATOR)
(760) 757-7546
Entity
Organization
Contact information
Practice address
530 LOMAS SANTA FE DR STE D, SOLANA BEACH, CA 92075-1346
(858) 259-0056
(858) 259-0187
Mailing address
3629 VISTA WAY, OCEANSIDE, CA 92056-4522
(760) 828-9201
(760) 828-9141
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881631711
GROUP NPI
CA
05
—
GR0029463
—
CA
Enumeration date
07/27/2007
Last updated
12/01/2008
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