Provider Demographics
NPI:1811776560
Name:WILLIAM F RESH MD, SKIN & SKIN CANCER MEDICAL GROUP OF SAN DIEGO, INC.
Entity type:Organization
Organization Name:WILLIAM F RESH MD, SKIN & SKIN CANCER MEDICAL GROUP OF SAN DIEGO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YARELI
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:CIFUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-267-8303
Mailing Address - Street 1:655 EUCLID AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2974
Mailing Address - Country:US
Mailing Address - Phone:619-267-8303
Mailing Address - Fax:619-267-4835
Practice Address - Street 1:15725 POMERADO RD STE 102
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2057
Practice Address - Country:US
Practice Address - Phone:619-267-8303
Practice Address - Fax:619-267-4835
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM F RESH MD, SKIN & SKIN CANCER MEDICAL GROUP OF SAN DIEGO, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty