Provider Demographics
NPI:1548364797
Name:ATKIN, DEBORAH HOPE (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:HOPE
Last Name:ATKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12865 POINE DEL MAR WAY
Mailing Address - Street 2:STE 160
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014
Mailing Address - Country:US
Mailing Address - Phone:858-350-7546
Mailing Address - Fax:858-350-8282
Practice Address - Street 1:12865 POINE DEL MAR WAY
Practice Address - Street 2:STE 160
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014
Practice Address - Country:US
Practice Address - Phone:858-350-7546
Practice Address - Fax:858-350-8282
Is Sole Proprietor?:No
Enumeration Date:2006-09-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG79956207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G62136Medicare UPIN
WG79956EMedicare ID - Type Unspecified