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S. GAYLE WIDYOLAR M.D. INC. NPI 1457538415


NPI Information

NPI: 1457538415
Provider Name: S. GAYLE WIDYOLAR, M.D., INC.
Classification: Dermatology - 207N00000X
Entity Type: Organization
Address:
21 MONTECITO DR
CORONA DEL MAR, CA
ZIP 92625
Phone: (949) 760-2552
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S. GAYLE WIDYOLAR, M.D., INC. is a dermatology in Corona Del Mar, CA. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. S. GAYLE WIDYOLAR, M.D., INC. NPI is 1457538415. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

21 MONTECITO DR
CORONA DEL MAR, CA
ZIP 92625-017
Phone: (949) 760-2552
Fax: (949) 706-3808

The provider's authorized official is Sheila Gayle Widyolar .
The authorized official title is President and has the following contact phone number (949) 760-2552.

The enumeration date for this NPI number is 1/22/2008 and was last updated on 6/20/2008.


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
1207ND0900XDermatologyDermatopathologyNo
2207N00000XDermatologyYes

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
100G250560MEDICAIDCALIFORNIA
2G25056MEDICARE PINCALIFORNIA
3A42501MEDICARE UPINCALIFORNIA

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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