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DERMATOLOGY SPECIALISTS INC NPI 1053778274


NPI Information

NPI: 1053778274
Provider Name: DERMATOLOGY SPECIALISTS, INC
Classification: Physician Assistant - 363A00000X
Entity Type: Organization

CLIA Number: 05D2155665

Address:
31469 RANCHO PUEBLO RD # 101
TEMECULA, CA
ZIP 92592
Phone: (951) 304-7546
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DERMATOLOGY SPECIALISTS, INC is a physician assistant in Temecula, CA. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. DERMATOLOGY SPECIALISTS, INC NPI is 1053778274. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

31469 RANCHO PUEBLO RD # 101
TEMECULA, CA
ZIP 92592-834
Phone: (951) 304-7546

The provider's authorized official is Jane Lisk .
The authorized official title is Administrator and has the following contact phone number (760) 757-7546.

The CLIA number assigned to this NPI record is 05D2155665 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/19/2016 and was last updated on 1/19/2016.


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
1363A00000XPhysician AssistantPA14750CALIFORNIAYes

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
1ZZZ00530ZMEDICARE 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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