Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Quail Lakes Dermatology Medical Associates, Inc

Organization Specialist · NPI 1275536872

Quail Lakes Dermatology Medical Associates, Inc is a Specialist 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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