Glendora Dermatologic And Cosmetic Surgery Center in Glendora - Ambulatory Surgical
Glendora Dermatologic And Cosmetic Surgery Center - NPI 1043323801
Glendora Dermatologic And Cosmetic Surgery Center is a Ambulatory Surgical in Glendora, California. Glendora Dermatologic And Cosmetic Surgery Center practices all healthcare services and medical treatments related to Ambulatory Surgical. The NPI Number for Glendora Dermatologic And Cosmetic Surgery Center is 1043323801. The last update date is 2010-09-30.
Glendora Dermatologic And Cosmetic Surgery Center's current location address is 412 W Carroll Ave, Glendora, California. You can contact this provider via phone number 6263351606 and fax number 6269630575. The mailing address for Glendora Dermatologic And Cosmetic Surgery Center is 412 W Carroll Ave, Glendora, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Glendora Dermatologic And Cosmetic Surgery Center |
|---|---|
| Address | 412 W Carroll Ave, Glendora, California |
| Phone Number | 6263351606 |
| Fax Number | 6269630575 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER /PRE |
|---|---|
| Authorized Official Name | Gormley E Daniel |
| Credentials | MD |
| Telephone Number | 6263351606 |
NPI Number Detail
| NPI Number | 1043323801 |
|---|---|
| Provider Enumeration Date | 2006-08-16 |
| Last Updated Date | 2010-09-30 |
Provider Mailing Address Detail
| Address | 412 W Carroll Ave |
|---|---|
| City | Glendora |
| State | California (CA) |
| Post Code | 917414240 |
| Phone Number | 6263351606 |
| Fax Number | 6269630575 |
Provider's Primary Taxonomy Detail
| Speciality | Ambulatory Surgical |
|---|---|
| Taxonomy | 261Qa1903X |
|
Definition: Provides outpatient surgical services not requiring hospitalization. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| S551093 | CA | PTAN (MEDICARE LEGACY #) |
Post Comment/ Review Below
Where is the Glendora Dermatologic And Cosmetic Surgery Center located?
The Glendora Dermatologic And Cosmetic Surgery Center is located at 412 W Carroll Ave, Glendora, CA 917414240.
What is the Glendora Dermatologic And Cosmetic Surgery Center's specialty and taxonomy code?
The Glendora Dermatologic And Cosmetic Surgery Center's specialty is Ambulatory Surgical, and the corresponding taxonomy code is 261Qa1903X.
What is the area of specialization for Glendora Dermatologic And Cosmetic Surgery Center, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Glendora Dermatologic And Cosmetic Surgery Center is Ambulatory Surgical, and the corresponding taxonomy code that categorizes this area of expertise is 261Qa1903X.
On what date did the Centers for Medicare & Medicaid Services issue the 1043323801 to Glendora Dermatologic And Cosmetic Surgery Center?
The Glendora Dermatologic And Cosmetic Surgery Center received its 1043323801 assignment from the Centers for Medicare & Medicaid Services on 2006-08-16.
When was the Glendora Dermatologic And Cosmetic Surgery Center's information last updated?
The Glendora Dermatologic And Cosmetic Surgery Center's information was last updated on 2010-09-30.