Medderm Associates

LBN: Medderm Corporation
Medderm Associates is an health care organization with primary practice located at 3965 5Th Ave Ste 200 , San Diego CA 92103-3107. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Medderm Corporation can be contacted via phone (619) 542-0013, or through Pelle, Michelle Terez via phone (619) 542-0013.

Contact Information

Primary practice address
3965 5Th Ave Ste 200 San Diego CA 92103-3107
Phone: (619) 542-0013
Fax: (619) 542-0559
Website:
Map and Directions
Authorized official contact:
Name: Pelle, Michelle Terez Doctor of Medicine (MD)
Phone: (619) 542-0013

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X A88009 California

Profile Details

NPI number 1063447936
LBN Legal business name Medderm Corporation
DBA Doing business as Medderm Associates
Authorized official Pelle, Michelle Terez Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 11th, 2006
Last updated Apr 18th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063447936 NPPES
California MEDICAID 00A880090

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