Basic Information
| Provider Information | |||||||||
| NPI: | 1487210365 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARTIUS DERMATOLOGY ASSOCIATES P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 101868 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911891868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9568030748 | ||||||||
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| Practice Location | |||||||||
| Address1: | 325 MALL DR STE 111 | ||||||||
| Address2: | |||||||||
| City: | HANFORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932305950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5595837546 | ||||||||
| FaxNumber: | 5595836062 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2019 | ||||||||
| LastUpdateDate: | 05/06/2020 | ||||||||
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| AuthorizedOfficialLastName: | MISTAK | ||||||||
| AuthorizedOfficialFirstName: | RONALD | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 3612481505 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332900000X | Y | Suppliers | Non-Pharmacy Dispensing Site |
No ID Information.