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ALAMITOS DERMATOLOGICAL MEDICAL CLINIC INC NPI 1588911549


NPI Information

NPI: 1588911549
Provider Name: ALAMITOS DERMATOLOGICAL MEDICAL CLINIC, INC

Doing Business As: COASTAL DERMATOLOGY AND PLASTIC SURGERY

Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 05D0946569

Address:
17822 BEACH BLVD
SUITE 427
HUNTINGTON BEACH, CA
ZIP 92647
Phone: (714) 842-7796
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ALAMITOS DERMATOLOGICAL MEDICAL CLINIC, INC is a specialist in Huntington Beach, 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. ALAMITOS DERMATOLOGICAL MEDICAL CLINIC, INC NPI is 1588911549. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Coastal Dermatology And Plastic Surgery.

The provider's business location address is:

17822 BEACH BLVD
SUITE 427
HUNTINGTON BEACH, CA
ZIP 92647-101
Phone: (714) 842-7796
Fax: (714) 842-9206

The provider's authorized official is Matthew Bart Luxenberg .
The authorized official title is Secretary/treasurer and has the following contact phone number (562) 598-8593.

The CLIA number assigned to this NPI record is 05D0946569 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/9/2012 and was last updated on 8/9/2012.


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
1174400000XSpecialistYes

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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