MIREMADI DERMATOLOGY MEDICAL CORPORATION NPI 1760663116

NPI Information

NPI: 1760663116
Provider Name: MIREMADI DERMATOLOGY MEDICAL CORPORATION
Classification: Dermatology - 207ND0900X
Entity Type: Organization

Specialization: Dermatopathology

CLIA Number: 05D0684137

Address:
7702 IVANHOE AVE
LA JOLLA, CA
ZIP 92037
Phone: (858) 456-1840
Get Directions

MIREMADI DERMATOLOGY MEDICAL CORPORATION is a dermatopathology dermatology in La Jolla, 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. MIREMADI DERMATOLOGY MEDICAL CORPORATION NPI is 1760663116. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7702 IVANHOE AVE
LA JOLLA, CA
ZIP 92037-520
Phone: (858) 456-1840

The provider's authorized official is Arjang K Miremadi .
The authorized official title is Physician/owner and has the following contact phone number (858) 456-1840.

The CLIA number assigned to this NPI record is 05D0684137 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 11/14/2007 and was last updated on 12/20/2007.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207NI0002X	Dermatology	Clinical & Laboratory Dermatological Immunology	A31016	CALIFORNIA	No
2	207NP0225X	Dermatology	Pediatric Dermatology	A31016	CALIFORNIA	No
3	207NS0135X	Dermatology	Procedural Dermatology	A31016	CALIFORNIA	No
4	207ND0900X	Dermatology	Dermatopathology	A31016	CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A99764	MEDICARE UPIN	CALIFORNIA
2	00A310160	MEDICAID	CALIFORNIA

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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