Individual
STEPHANIE KELTER FOGELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 CORPORATE DR, SUITE #240, LADERA RANCH, CA 92694-2106
(949) 364-8411
(949) 364-8511
Mailing address
600 CORPORATE DR, SUITE #240, LADERA RANCH, CA 92694-2106
(949) 364-8411
(949) 364-8511
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A92164
CA
Other
Enumeration date
02/08/2008
Last updated
10/07/2014
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