Organization
WEST DERMATOLOGY OF ARIZONA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J. ROBERT WEST SR. M.D. (PRESIDENT)
(909) 335-8649
Entity
Organization
Contact information
Practice address
560 W BROWN RD, SUITE 4001, MESA, AZ 85201-3221
(480) 962-4269
(480) 962-3702
Mailing address
PO BOX 2048, REDLANDS, CA 92373-0641
(909) 335-8649
(909) 335-1994
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS4930
RAILROAD MEDICARE
AZ
Enumeration date
05/19/2006
Last updated
01/06/2009
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