MEDICARE: DOCTORS OF DERMATOLOGY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	20A8307	CA

General Provider Information

NPI Number	:	1659589844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS OF DERMATOLOGY INC

Provider Business Mailing Address
First Line	:	27141 HIDAWAY AVE
Second Line	:	SUITE 104
City	:	SANTA CLARITA
State	:	CA
Zip	:	91351-4131
Country	:	US
Telephone Number	:	661-299-6900
Fax Number	:	661-299-1300

Provider Business Practice Location Address
First Line	:	27141 HIDAWAY AVE
Second Line	:	SUITE 104
City	:	SANTA CLARITA
State	:	CA
Zip	:	91351-4131
Country	:	US
Telephone Number	:	661-299-6900
Fax Number	:	661-299-1300

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ARAM H. KECHICHIAN
Credential	:	D.O.
Telephone Number	:	661-299-6900

Provider Enumeration Date	:	05/19/2007
Last Update Date	:	02/26/2011

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Practice Location Address:

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