Bayside Dermatology Incorporated
Dermatology in San Diego, CA. Organization (NPI-2).
NPI number1982803821
StatusActive
Last updated in NPPESJul 12, 2007
Details
- NPI
- 1982803821
- Entity type
- Organization (NPI-2)
- Legal business name
- Bayside Dermatology Incorporated
- Organization subpart
- No
- Enumeration date
- Jul 12, 2007
- Last updated
- Jul 12, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | A79823 | CA | Yes |
| 207ND0101X | Dermatology, MOHS-Micrographic Surgery | A79823 | CA | |
| 207ND0900X | Dermatology, Dermatopathology | A79823 | CA | |
| 207NI0002X | Dermatology, Clinical & Laboratory Dermatological Immunology | A79823 | CA | |
| 207NS0135X | Dermatology, Procedural Dermatology | A79823 | CA | |
| 207NP0225X | Dermatology, Pediatric Dermatology | A79823 | CA |
Practice location
8174 Regents Rd Apt 303San Diego, CA 92122-1371
Phone 858-552-8096
Mailing address
8174 Regents Rd Apt 303San Diego, CA 92122-1371
Authorized official
Bryan Chen
Owner
8585528096
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