Organization
MAGNOLIA DERMATOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BABAK ROSHDIEH M.D. (OWNER)
(951) 734-6500
Entity
Organization
Contact information
Practice address
770 MAGNOLIA AVE, SUITE 2G, CORONA, CA 92879-3120
(951) 734-6500
(951) 734-6555
Mailing address
770 MAGNOLIA AVE, SUITE 2G, CORONA, CA 92879-3120
(951) 734-6500
(951) 734-6555
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A76333
CA
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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