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DR. ROLAND SPURGEON BEVERLY M.D.
MOHS-Micrographic Surgery >> Dermatology >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1083687776
Individual Registrant:DR. ROLAND SPURGEON BEVERLY M.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
24541 PACIFIC PARK DR SUITE 103 ALISO VIEJO, CA 92656-3065 US
Tel: 949-831-3057 Fax: 949-831-2515
Tel: 949-831-3057 Fax: 949-831-2515
Contact information for business:
24541 PACIFIC PARK DR SUITE 103 ALISO VIEJO, CA 92656-3065 US
Tel: 949-831-3057 Fax: 949-831-2515
Tel: 949-831-3057 Fax: 949-831-2515
Registration Information:
NPI: 1083687776
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 207ND0101X | Allopathic & Osteopathic Physicians Dermatology MOHS-Micrographic Surgery | CA | G65658 |
| Y | 207N00000X | Allopathic & Osteopathic Physicians Dermatology | CA | G65658 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
