ADVANCED DERMATOLOGY CARE INC. NPI 1043536543

NPI Information

NPI: 1043536543
Provider Name: ADVANCED DERMATOLOGY CARE, INC.

Doing Business As: DBA: CALIFORNIA DERMATOLOGY CARE

Classification: Surgery - 2086S0122X
Entity Type: Organization

Specialization: Plastic and Reconstructive Surgery

CLIA Number: 05D2007864

Address:
2262 CAMINO RAMON
SAN RAMON, CA
ZIP 94583
Phone: (925) 328-0255
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ADVANCED DERMATOLOGY CARE, INC. is a plastic and reconstructive surgery surgery in San Ramon, CA. The provider is a surgeon who specializes in plastic and reconstructive surgery. ADVANCED DERMATOLOGY CARE, INC. NPI is 1043536543. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Dba: California Dermatology Care.

The provider's business location address is:

2262 CAMINO RAMON
SAN RAMON, CA
ZIP 94583
Phone: (925) 328-0255
Fax: (925) 328-0257

The provider's authorized official is Flora Ting .
The authorized official title is Office Manager and has the following contact phone number (925) 328-0255.

The CLIA number assigned to this NPI record is 05D2007864 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/9/2010 and was last updated on 6/4/2014.

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	207N00000X	Dermatology		A82266	CALIFORNIA	No
2	2086S0122X	Surgery	Plastic and Reconstructive Surgery	A82266	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	U81729	MEDICARE UPIN	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: 11/14/2023

NPI Synchronization or Removal

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