WILLIAM J WICKWIRE, M.D., INC., (NPI# 1326119165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326119165 |
| Entity Type | Organization |
| Organization Name | WILLIAM J WICKWIRE, M.D., INC., |
| Other Organization Name | BEACH CITIES DERMATOLOGY MEDICAL CENTER |
| Practice Address |
520 N Prospect Ave Ste 302 Redondo Beach CA 90277-3041 |
| Practice Telephone | 3107981515 |
| Practice Fax Number | 3107983131 |
| Mailing Telephone | 3107981515 |
| Mailing Fax Number | 3107983131 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2008-05-06 |
| Authorized Official Name | DR. WILLIAM J WICKWIRE (OWNER) |
| Authorized Official Telephone | 3107981515 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | G650830 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G650830 | 05 | |
| CA | MEDICARE NORTHERN CA ID | 00G650830 | 01 |
| Other Name | Type Code |
|---|---|
| Beach Cities Dermatology Medical Center | Doing Business As Name - Organization |
| Street Address |
520 N PROSPECT AVE STE 302 |
| City | REDONDO BEACH |
| State | CA |
| Zip Code | 90277-3041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699779660 | William James Wickwire | Dermatology | 520 N Prospect Ave, Ste 302, Redondo Beach, CA 90277-3043 | 2005-06-08 |
| 1265980437 | Nitin Bhakta | Pharmacist | 520 N Prospect Ave, Suite 110, Redondo Beach, CA 90277-3041 | 2016-09-16 |
| 1356799415 | A. R. I. Clinical Trials, Inc. | Clinic/Center | 520 N Prospect Ave, Suite 201, Redondo Beach, CA 90277-3041 | 2016-05-31 |
| 1962866483 | Jamie W Wu | Registered Nurse | 520 N Prospect Ave, Suite 203, Redondo Beach, CA 90277-3041 | 2016-04-11 |
| 1225463797 | Los Angeles Ent Facial Plastics Center, Inc | Clinic/Center | 520 N Prospect Ave, Suite 302, Redondo Beach, CA 90277-3041 | 2013-09-03 |
| 1053669390 | Brenda Shen | Family Medicine | 520 N Prospect Ave, Suite 103, Redondo Beach, CA 90277-3041 | 2012-08-16 |
| 1346536968 | Sitaraman Jyotheeswaran Md Facp A Medical Corporation | Internal Medicine | 520 N Prospect Ave, Suite # 304, Redondo Beach, CA 90277-3041 | 2011-06-22 |
| 1952617342 | Lewis Wong | Family Medicine | 520 N Prospect Ave, Redondo Beach, CA 90277-3041 | 2010-08-24 |
| 1942452453 | Michael S. Greiner | Chiropractor | 520 N Prospect Ave, Ste # 201, Redondo Beach, CA 90277-3041 | 2008-10-15 |
| 1164672796 | Melody Lee | Nurse Practitioner | 520 N Prospect Ave, Redondo Beach, CA 90277-3041 | 2008-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780215103 | Robert John Coffman | Psychologist | 316b North Pacific Coast Hwy., Redondo Beach, CA 90277 | 2020-02-04 |
| 1952949786 | Anne E Pitts | Dietitian, Registered | 360 The Village Drive Unit 207, Redondo Beach, CA 90277 | 2019-12-11 |
| 1558916841 | Dana Bryon Staub | Social Worker | 205 Ave. I, Suite 17, Redondo Beach, CA 90277 | 2019-08-05 |
| 1376033860 | Lisa Ann Graziano | Marriage & Family Therapist | 514 N. Prospect Avenue, Suite 111 Lower Level, Redondo Beach, CA 90277 | 2018-05-10 |
| 1275981326 | Carla Marie Vasquez | Marriage & Family Therapist | 901 N. Pacific Coast Highway, 200a, Redondo Beach, CA 90277 | 2016-05-31 |
| 1154793628 | Marianne M. Cuttic, Dpm, Inc | Podiatrist | 1970 S Prospect Avenue, Suite 4, Redondo Beach, CA 90277 | 2015-10-23 |
| 1841682994 | Mary Schopfel | Counselor | 901 Pacific Coast Highway, 200a, Redondo Beach, CA 90277 | 2015-02-26 |
| 1700287141 | Rose Ross | Marriage & Family Therapist | 901 North Pacific Coast Highway, Suite 200a, Redondo Beach, CA 90277 | 2014-09-04 |
| 1912307661 | Gale Hazeltine | Physical Therapist | 409 N PCh Hwy # 308, Redondo Beach, CA 90277 | 2014-08-31 |
| 1194135889 | Physical Therapy Concierge Service Inc | Clinic/Center | 704 N. Irena, B, Redondo Beach, CA 90277 | 2014-05-02 |
| Find all providers in zip 90277 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790225829 | Spade Skin Care Medical Inc | Dermatology | 1611 S Catalina Ave Ste L70, Redondo Beach, CA 90277-5296 | 2017-03-08 |
| 1093059610 | Annie Chiu Md, Inc | Dermatology | 1636 Aviation Blvd, Suite 201, Redondo Beach, CA 90278-2851 | 2012-11-20 |
| 1558641936 | Anabella Pascucci | Dermatology | 514 N Prospect Ave Ste 103, Redondo Beach, CA 90277-3037 | 2011-08-17 |
| 1841241205 | John F Gebhard | Dermatology | 217 Avenida Del Norte, Redondo Beach, CA 90277-5702 | 2006-05-12 |
| 1699779660 | William James Wickwire | Dermatology | 520 N Prospect Ave, Ste 302, Redondo Beach, CA 90277-3043 | 2005-06-08 |
| 1447679865 | Teo Soleymani | Dermatology | 514 N Prospect Ave, Redondo Beach, CA 90277-3036 | 2014-04-14 |
| 1851460950 | Neal M Ammar | Dermatology | 520 N Prospect Ave, Ste 302, Redondo Beach, CA 90277-3041 | 2006-11-06 |
| 1982797593 | Sanusi Hambali Umar | Dermatology | 819 N Harbor Dr, Suite 400, Redondo Beach, CA 90277-2006 | 2006-10-02 |
| 1639103138 | Geover Fernandez | Dermatology | 520 N Prospect Ave, Suite 302, Redondo Beach, CA 90277-3041 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275144024 | Lumins Aesthetic and Wellness, Inc | Dermatology | 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 | 2020-08-14 |
| 1669081204 | Lucy Boyadzhian | Dermatology | 7472 Melrose Ave, Los Angeles, CA 90046-7524 | 2020-07-29 |
| 1033730981 | Adrianna Janell Browne, Md, Inc. | Dermatology | 8 Camino Encinas Ste 115, Orinda, CA 94563-3350 | 2020-05-01 |
| 1215564877 | Jasmine Khachatrian | Dermatology | 302 Sierra Woods Dr, Sierra Madre, CA 91024-1015 | 2020-03-24 |
| 1386277499 | Jessica Hsu, M.d.,inc | Dermatology | 1506 Chapman Avenue, Address Line 2, Orange, CA 92866 | 2020-02-17 |
| 1245862101 | Yuval Bibi, A Professional Corporation | Dermatology | 7266 Franklin Ave Apt 321, Los Angeles, CA 90046-8324 | 2020-02-09 |
| 1457982001 | Modesty Joy Isaguirre | Dermatology | 140 S Grand Ave, Glendora, CA 91741-4259 | 2020-02-03 |
| 1790322063 | Mfc Dermatology | Dermatology | 3655 Lomita Blvd Ste 221, Torrance, CA 90505-1918 | 2019-12-05 |
| 1336784206 | Barbara Kinkle Pa Inc., A Physician Assistant Corporation | Dermatology | 24575 Hunt Ave, Corning, CA 96021-8607 | 2019-11-14 |
| 1497399141 | Dermatology Specialists Inc | Dermatology | 4765 Carmel Mountain Rd Ste 201, San Diego, CA 92130-6657 | 2019-11-05 |
| Find all providers with the same taxonomy | ||||
| City | REDONDO BEACH |
| Zip Code | 90277 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.