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Contact Information

INNOVATIVE DERMATOLOGY ALLIANCE CA
5530 AVENIDA DE LOS ROBLES
VISALIA, CA93291
 Phone: 559-733-5050
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for INNOVATIVE DERMATOLOGY ALLIANCE CA · (Female)

NPI Number 1083188221
Status Active
Credentials
Entity Individual
Enumeration date 01/21/2019
Last updated 05/14/2026 - About 3 weeks ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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