Healthcare Provider Details

I. General information

NPI: 1376542340
Provider Name (Legal Business Name): NORMAN M PRICE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VIA HERMOSA
ORINDA CA
94563-1827
US

IV. Provider business mailing address

1 VIA HERMOSA
ORINDA CA
94563-1827
US

V. Phone/Fax

Practice location:
  • Phone: 925-963-6399
  • Fax:
Mailing address:
  • Phone: 925-963-6399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA26516
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberA26516
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberA26516
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: