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Individual

DR. DALE RAYMOND WESTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., PH.D.

Contact information

Practice address
990 SONOMA AVE STE 2, SANTA ROSA, CA 95404-4813
(707) 579-4239
(707) 579-0459
Mailing address
990 SONOMA AVE STE 2, SANTA ROSA, CA 95404-4813
(707) 579-4239

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G46342
CA
207ND0900X
Dermatopathology Physician
G46242
CA
207NS0135X
Procedural Dermatology Physician
G46342
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G46342
CA
Enumeration date
07/11/2006
Last updated
06/17/2008
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