Provider Demographics
NPI:1376091553
Name:INTEGRATED DERMATOLOGY OF MISSION VIEJO, APMC
Entity Type:Organization
Organization Name:INTEGRATED DERMATOLOGY OF MISSION VIEJO, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:Q
Authorized Official - Last Name:ZHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-479-4884
Mailing Address - Street 1:26691 PLAZA STE 230
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6300
Mailing Address - Country:US
Mailing Address - Phone:949-364-2904
Mailing Address - Fax:949-364-2909
Practice Address - Street 1:26691 PLAZA STE 230
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6300
Practice Address - Country:US
Practice Address - Phone:949-364-2904
Practice Address - Fax:949-364-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty