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General NPI Number Information
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NPI Number | 1407474273
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Entity Type | Organization
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Legal Business Name | GOOD DERM, INC
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Dates
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Enumeration Date | 07/08/2020
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 3640 LOMITA BLVD STE 301
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City | TORRANCE
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State | CA
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Zip | 90505-3956
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Country | US
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Telephone | 310-405-0693
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Fax | 310-356-9126
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Provider Business Mailing Address
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Address Line | 3640 LOMITA BLVD STE 301
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City | TORRANCE
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State | CA
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Zip | 90505-3956
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Country | US
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Telephone | 310-405-0693
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Fax | 310-356-9126
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CONSUELO VERONICA DAVID
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Credential | MD
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Telephone | 301-655-8058
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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 |
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License Number State |
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