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DERMATOLOGY & LASER MEDICAL CTR INC NPI 1326299496


NPI Information

NPI: 1326299496
Provider Name: DERMATOLOGY & LASER MEDICAL CTR INC
Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

Address:
16260 VENTURA BLVD
SUITE 140
ENCINO, CA
ZIP 91436
Phone: (818) 528-2500
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DERMATOLOGY & LASER MEDICAL CTR INC is a procedural dermatology dermatology in Encino, CA. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). DERMATOLOGY & LASER MEDICAL CTR INC NPI is 1326299496. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

16260 VENTURA BLVD
SUITE 140
ENCINO, CA
ZIP 91436-203
Phone: (818) 528-2500
Fax: (818) 528-2505

The provider's authorized official is Alex A Khadavi .
The authorized official title is Owner and has the following contact phone number (818) 528-2500.

The enumeration date for this NPI number is 10/7/2008 and was last updated on 7/18/2011.


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
1207ND0101XDermatologyMOHS-Micrographic SurgeryA71517CALIFORNIANo
2207ND0900XDermatologyDermatopathologyA71517CALIFORNIANo
3207NS0135XDermatologyProcedural DermatologyA71517CALIFORNIAYes

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
1H70923MEDICARE UPINCALIFORNIA
2W16663MEDICARE 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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