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General NPI Number Information
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NPI Number | 1174728513
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY ASSOCIATES OF ORANGE COUNTY, INC
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Dates
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Enumeration Date | 06/17/2007
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 31862 COAST HWY SUITE 201
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-6769
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Country | US
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Telephone | 949-706-7766
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Fax | 949-706-2211
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Provider Business Mailing Address
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Address Line | 31862 COAST HWY SUITE 201
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-6769
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Country | US
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Telephone | 949-706-7766
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Fax | 949-706-2211
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANN Q VU
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Credential | MD
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Telephone | 949-706-7766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | BS7402299
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License Number State | CA
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