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COMPREHENSIVE DERMATOLOGY CENTER OF PASADENA A MEDICAL GROUP NPI 1740485010


NPI Information

NPI: 1740485010
Provider Name: COMPREHENSIVE DERMATOLOGY CENTER OF PASADENA, A MEDICAL GROUP
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

CLIA Number: 05D2024886

Address:
625 S FAIR OAKS AVE
SUITE 200
PASADENA, CA
ZIP 91105
Phone: (626) 793-7790
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COMPREHENSIVE DERMATOLOGY CENTER OF PASADENA, A MEDICAL GROUP is a medical specialty clinic center in Pasadena, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). COMPREHENSIVE DERMATOLOGY CENTER OF PASADENA, A MEDICAL GROUP NPI is 1740485010. The provider is registered as an organization entity type.

The provider's business location address is:

625 S FAIR OAKS AVE
SUITE 200
PASADENA, CA
ZIP 91105-613
Phone: (626) 793-7790
Fax: (626) 793-9018

The provider's authorized official is Han N. Lee .
The authorized official title is Director and has the following contact phone number (626) 793-7790.

The CLIA number assigned to this NPI record is 05D2024886 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/18/2007 and was last updated on 7/6/2011.


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
1261QM2500XClinic/CenterMedical SpecialtyA80177CALIFORNIAYes

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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