Healthcare Provider Details

I. General information

NPI: 1902908197
Provider Name (Legal Business Name): ALLSKIN DERMATOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 TELEGRAPH AVE 2ND FLOOR
BERKELEY CA
94705
US

IV. Provider business mailing address

2828 TELEGRAPH AVE 2ND FLOOR
BERKELEY CA
94705
US

V. Phone/Fax

Practice location:
  • Phone: 510-848-8404
  • Fax: 510-848-6312
Mailing address:
  • Phone: 510-848-8404
  • Fax: 510-848-6312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG84385
License Number StateCA

VIII. Authorized Official

Name: DR. TERRI RENEE DUNN
Title or Position: OWNER
Credential: MD
Phone: 510-848-8404