Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Quail Lakes Dermatology Medical Associates, Inc

Organization Specialist · NPI 1275536872

Quail Lakes Dermatology Medical Associates, Inc provides Specialist services in Stockton, California. Licensed in California. Registered with an NPI since 2005.

Licensed in
CA
In the registry since
2005
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4553 Quail Lakes Dr
Stockton, CA 95207-5257
Phone: (209) 951-1133
Fax: (209) 951-4708
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence A068815 (CA)

Record details

NPI number1275536872
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kyle Herbold — Dermatologist · (209) 951-1133
NPI enumeratedMay 27, 2005
Last updated in NPPESAugust 22, 2020
Mailing address4553 Quail Lakes Dr, Stockton, CA 95207-5257

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