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General NPI Number Information
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NPI Number | 1578097689
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Entity Type | Organization
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Legal Business Name | CALIBER DERMATOLOGY, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/14/2017
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Last Update Date | 04/14/2017
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Provider Practice Location Address
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Address Line | 2459 HUNTINGTON DR
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City | SAN MARINO
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State | CA
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Zip | 91108-2644
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Country | US
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Telephone | 626-808-7081
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 80820
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City | SAN MARINO
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State | CA
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Zip | 91118-8820
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NOR CHIAO
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Credential | M.D.
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Telephone | 626-808-7081
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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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