| Organization Name: | DERMATOLOGY&LASER CENTER OF SAN DIEGO |
| NPI Number: | 1457396178 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SARA ROSALES (INSURANCE SPECIALIST) |
| Mailing Address: | 319 F St 102 Chula Vista |
| State: | CA US |
| Postal Code: | 919102666 |
| Phone Number: | 6194761200 |
| Fax Number: | 6194207849 |
| NPI Enumeration Date: | 06/17/2006 |
| NPI Last Update Date: | 11/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | C36597 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |