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General NPI Number Information
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NPI Number | 1982179065
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Entity Type | Organization
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Legal Business Name | ROXBURY DERMATOLOGY AND MULTISPECIALTY PRACTICE INC
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Dates
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Enumeration Date | 10/04/2018
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Last Update Date | 10/04/2018
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Provider Practice Location Address
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Address Line | 450 N ROXBURY DR STE 410
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4231
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Country | US
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Telephone | 884-544-1617
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Fax | 424-394-1627
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Provider Business Mailing Address
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Address Line | 450 N ROXBURY DR STE 410
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4231
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Country | US
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Telephone | 884-544-1617
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Fax | 424-394-1627
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID M AMRON
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Credential | M. D.
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Telephone | 844-544-1617
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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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