White Mountain Dermatology Llc

LBN: White Mountain Dermatology Llc
White Mountain Dermatology Llc is an health care organization with primary practice located at 288 N Ironwood Dr Suite 105, Apache Junction AZ 85220-3830. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Procedural Dermatology, which is considered as the primary health care specialty. White Mountain Dermatology Llc can be contacted via phone (480) 671-4086, or through Brual, Gerardo C via phone (480) 671-4086.

Contact Information

Primary practice address
288 N Ironwood Dr Suite 105 Apache Junction AZ 85220-3830
Phone: (480) 671-4086
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Brual, Gerardo C Doctor of Medicine (MD)
Phone: (480) 671-4086

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X

Profile Details

NPI number 1033164538
LBN Legal business name White Mountain Dermatology Llc
DBA Doing business as
Authorized official Brual, Gerardo C Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2006
Last updated Apr 7th, 2015 - about 9 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 1033164538 NPPES
Arizona Other 070013565 RAIL ROAD MEDICARE

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