Organization
PURE DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEDA MEHR M.D. (PRESIDENT)
(949) 413-7336
Entity
Organization
Contact information
Practice address
500 SUPERIOR AVE, STE 335, NEWPORT BEACH, CA 92663-3657
(949) 706-1469
(949) 706-7307
Mailing address
500 SUPERIOR AVE, STE 335, NEWPORT BEACH, CA 92663-3657
(949) 706-1469
(949) 706-7307
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A105012
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HA571A
MEDICARE PTAN
CA
Enumeration date
02/01/2013
Last updated
08/04/2016
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