Palm Canyon Dermatology, Pc

LBN: Palm Canyon Dermatology, Pc
Palm Canyon Dermatology, Pc is an health care organization with primary practice located at 350 W Catalina Dr , Yuma AZ 85364-8112. The organization recently has only one registered license in Managed Care Organizations / Point of Service, which is considered as the primary health care specialty. Palm Canyon Dermatology, Pc can be contacted via phone (928) 344-0650, or through Ertl, Gregory Andrew via phone (928) 344-0650.

Contact Information

Primary practice address
350 W Catalina Dr Yuma AZ 85364-8112
Phone: (928) 344-0650
Fax: (928) 344-3928
Website:
Map and Directions
Authorized official contact:
Name: Ertl, Gregory Andrew Doctor of Medicine (MD)
Phone: (928) 344-0650

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Point of Service 305S00000X 19732 Arizona

Profile Details

NPI number 1437339470
LBN Legal business name Palm Canyon Dermatology, Pc
DBA Doing business as
Authorized official Ertl, Gregory Andrew Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 7th, 2007
Last updated Nov 16th, 2007 - about 18 years ago

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 1437339470 NPPES
Other CG5646 RAIL ROAD MEDICARE

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