Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Nov 10, 2005
License(s)
20a8900 (CA), 20A8900 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2295 FIELDSTONE DRIVE SUITE 150 | Lincoln, CA 95648 | 530-527-0414 |
| MAILING | 2295 FIELDSTONE DRIVE SUITE 150 | Lincoln, CA 95648 | 530-527-0414 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.