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DERMATOLOGY & LASER MEDICAL CENTER INC NPI 1235269473


NPI Information

NPI: 1235269473
Provider Name: DERMATOLOGY & LASER MEDICAL CENTER INC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
16260 VENTURA BLVD
SUITE 140
ENCINO, CA
ZIP 91436
Phone: (818) 528-2500
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DERMATOLOGY & LASER MEDICAL CENTER INC is a specialist in Encino, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DERMATOLOGY & LASER MEDICAL CENTER INC NPI is 1235269473. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

16260 VENTURA BLVD
SUITE 140
ENCINO, CA
ZIP 91436-203
Phone: (818) 528-2500
Fax: (818) 528-2505

The provider's authorized official is Alex A Khadavi .
The authorized official title is Owner and has the following contact phone number (818) 528-2500.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 12/1/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207NS0135XDermatologyProcedural DermatologyA71517CALIFORNIANo
2174400000XSpecialistA71517CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H70923MEDICARE UPINCALIFORNIA
2W16663MEDICARE PINCALIFORNIA
3CB236700MEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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