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Contact Information

ROLAND S BEVERLY III, MD
24541 PACIFIC PARK DR
SUITE 103
ALISO VIEJO, CA92656-3065
 Phone: 949-831-3057
 Fax: 949-831-2515
 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 ROLAND S BEVERLY III · (Male)

NPI Number 1083687776
Status Active
Credentials MD
Entity Individual
Enumeration date 02/11/2006
Last updated 05/10/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • CA License # G65658
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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