Organization

Dermatology West, Llc

Clinic/Center in Westlake, OH(View on Map)

Legal Business Name

Dermatology West, Llc

NPI Number

1053521021

NPI Type

Organization

Enumeration Date

05/22/2007

Specialties

(Taxonomies)

Code

261Q00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

1445 CASTRO ST
26410 CENTER RIDGE RD

City

San Francisco
Westlake

State

CA
OH

Postal Code

94114-3717
44145-4067

Country

US
US

Telephone Number

(440) 858-3176
(440) 858-3176

Authorized Official

Name

Dr. Kyle Wagamon

Title or Position

OWNER

Telephone Number

(440) 858-3176

Identifiers

Identifier

1780758003

Identifier State

CA

Identifier Issuer

PERSONAL NPI

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/22/2020

Provider Address

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