Organization
DOUGLAS A. BLOSE M.D.,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS ALAN BLOSE M.D (PRESIDENT)
(562) 923-6450
Entity
Organization
Contact information
Practice address
11525 BROOKSHIRE AVE, STE 101, DOWNEY, CA 90241-4985
(562) 923-6450
(562) 923-0049
Mailing address
11525 BROOKSHIRE AVE STE 101, DOWNEY, CA 90241-4982
(562) 923-6450
(562) 923-0049
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G50355
CA
207ND0101X
MOHS-Micrographic Surgery Physician
G50355
CA
207ND0900X
Dermatopathology Physician
G50355
CA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
G50355
CA
207NP0225X
Pediatric Dermatology Physician
G50355
CA
207NS0135X
Procedural Dermatology Physician
G50355
CA
Other
Enumeration date
11/09/2007
Last updated
11/09/2007
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