Quail Lakes Dermatology Medical Associates, Inc.

NPI 1275536872 - Specialist - 174400000X

NPI Details
NPI 1275536872
Enumeration Date 05/27/2005
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 12 years ago
Authorized Information
Name KYLE WAYNE KYLE
Position DERMATOLOGIST
Phone (209) 951-1133
Fax (209) 951-4708
Practice Location
4553 QUAIL LAKES DR
STOCKTON CA, 95207-5257, US
Phone (209) 951-1133
Fax (209) 951-4708
Business Location
4553 QUAIL LAKES DR
STOCKTON CA, 95207-5257, US
Phone (209) 951-1133
Fax (209) 951-4708
Toxanomy
Taxonomy Code 174400000X
License State California
License Number A068815
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According to our database, Quail Lakes Dermatology Medical Associates, Inc. NPI is 1275536872, taxonomy code is 174400000X and license number is A068815, license state is located at California. Quail Lakes Dermatology Medical Associates, Inc. physically located at 4553 Quail Lakes Dr, Stockton CA, 95207-5257. NPI Number 1033115704 has the healthcare provider type.

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1275536872 NPI number is provided on an as is basis without warranty of any kind. 1275536872 is maintained by the National Plan & Provider Enumeration System. The contents of Quail Lakes Dermatology Medical Associates, Inc. are for informational purposes only.