Mountain West Derm California PC

NPI #1205346061 in Truckee, California

Provider Information

NPI Number: 1205346061
Entity Type: Organization
Organization Name: Mountain West Derm California PC
Primary Specialty: Dermatology
Enumeration Date: Oct 6, 2017
Last Updated: Aug 13, 2018

Practice Location

Address: 10870 BROCKWAY RD
City: Truckee
State: California
ZIP Code: 96161
Phone: (530) 550-0440

Authorized Official

Name: BRET BLACKHART, MD
Title: MD
Phone: (775) 560-8668

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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