Organization
ADVANCED DERMATOLOGY & SKIN CANCER SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE DAVID MITCHELL M.D. (PRESIDENT)
(951) 303-6900
Entity
Organization
Contact information
Practice address
31720 TEMECULA PKWY, SUITE #203, TEMECULA, CA 92592-5802
(951) 303-6900
(951) 303-2900
Mailing address
31720 TEMECULA PKWY, SUITE #203, TEMECULA, CA 92592-5802
(951) 303-6900
(951) 303-2900
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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