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DIAMOND BAR DERMATOLOGY CENTER NPI 1578597001


NPI Information

NPI: 1578597001
Provider Name: DIAMOND BAR DERMATOLOGY CENTER
Classification: Dermatology - 207N00000X
Entity Type: Organization
Address:
1200 S DIAMOND BAR BLVD
SUITE #201
DIAMOND BAR, CA
ZIP 91765
Phone: (909) 860-7600
Get Directions

DIAMOND BAR DERMATOLOGY CENTER is a dermatology in Diamond Bar, 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. DIAMOND BAR DERMATOLOGY CENTER NPI is 1578597001. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1200 S DIAMOND BAR BLVD
SUITE #201
DIAMOND BAR, CA
ZIP 91765-298
Phone: (909) 860-7600
Fax: (909) 860-7460

The provider's authorized official is Joy Fortich .
The authorized official title is Billing Manager and has the following contact phone number (909) 860-7600.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 12/6/2011.


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 SurgeryG044761CALIFORNIANo
2207ND0900XDermatologyDermatopathologyG044761CALIFORNIANo
3207NP0225XDermatologyPediatric DermatologyG044761CALIFORNIANo
4207NS0135XDermatologyProcedural DermatologyG044761CALIFORNIANo
5207N00000XDermatologyG044761CALIFORNIAYes

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
1W18423MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAPROVIDER NUMBER

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

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