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DESCANSO DERMATOLOGY MEDICAL GROUP NPI 1538161757


NPI Information

NPI: 1538161757
Provider Name: DESCANSO DERMATOLOGY MEDICAL GROUP
Classification: Dermatology - 207ND0900X
Entity Type: Organization

Specialization: Dermatopathology

CLIA Number: 05D0555481

Address:
1346 FOOTHILL BLVD
STE 203
LA CANADA, CA
ZIP 91011
Phone: (818) 790-6726
Get Directions

DESCANSO DERMATOLOGY MEDICAL GROUP is a dermatopathology dermatology in La Canada, CA. The provider is a dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. DESCANSO DERMATOLOGY MEDICAL GROUP NPI is 1538161757. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1346 FOOTHILL BLVD
STE 203
LA CANADA, CA
ZIP 91011-141
Phone: (818) 790-6726
Fax: (818) 790-9562

The provider's authorized official is John A Honch .
The authorized official title is Partner and has the following contact phone number (818) 790-6726.

The CLIA number assigned to this NPI record is 05D0555481 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/1/2005 and was last updated on 3/26/2008.


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
1207ND0900XDermatologyDermatopathologyG40665CALIFORNIAYes

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
1GR0082860MEDICAIDCALIFORNIA
2ZZZ157442OTHERBLUE SHIELD
3W10384MEDICARE ID-TYPE UNSPECIFIED

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: 11/14/2023

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