ALTA DERMATOLOGY GROUP LTD (NPI# 1780801506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780801506 |
| Entity Type | Organization |
| Organization Name | ALTA DERMATOLOGY GROUP LTD |
| Practice Address |
130 S 63rd St Bldg 3 Ste 114 Mesa AZ 85206-1620 |
| Practice Telephone | 4809812888 |
| Practice Fax Number | 4806540599 |
| Mailing Telephone | 4809812888 |
| Mailing Fax Number | 4806540599 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2014-10-22 |
| Authorized Official Name | REBECCA CASTILLO (OFFICE MANAGER) |
| Authorized Official Telephone | 4809812888 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
130 S 63RD ST BLDG 3 STE 114 |
| City | MESA |
| State | AZ |
| Zip Code | 85206-1620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053313643 | Diana Lynne Kesler-la Clair | Nurse Practitioner | 130 S 63rd St, Bldg 3 Suite 114, Mesa, AZ 85206-1620 | 2005-08-12 |
| 1770050288 | Tracy Nicole Clifford | Family Medicine | 130 S 63rd St, Mesa, AZ 85206-1620 | 2018-11-01 |
| 1740677079 | Ali Marzooq | Internal Medicine | 130 S 63rd St, Mesa, AZ 85206-1620 | 2015-04-24 |
| 1326432501 | Nicole Maria Jones | Nurse Practitioner | 130 S 63rd St, Ste 106, Mesa, AZ 85206-1620 | 2015-03-25 |
| 1174949754 | Chan Heart Rhythm Institute Pllc | Internal Medicine | 130 S 63rd St, Ste 106, Mesa, AZ 85206-1620 | 2014-03-06 |
| 1255763504 | Sonora Quest Laboratories, LLC | Clinical Medical Laboratory | 130 S 63rd St, Bldg 2, Ste 107, Mesa, AZ 85206-1620 | 2013-08-08 |
| 1023366507 | East Valley Urology, P.C. | Urology | 130 S 63rd St, Suite #101, Mesa, AZ 85206-1620 | 2012-08-15 |
| 1922378850 | Integrated Dermatology of Mesa Pllc | Dermatology | 130 S 63rd St, Suite 114, Mesa, AZ 85206-1620 | 2012-01-10 |
| 1700061363 | Dht Hand Therapy Limited Partnership | Durable Medical Equipment & Medical Supplies | 130 S 63rd St, Suite 110, Mesa, AZ 85206-1620 | 2008-01-02 |
| 1548335623 | Barry Sonkin | Urology | 130 S 63rd St, Suite #101, Mesa, AZ 85206-1620 | 2006-11-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| 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 |
|---|---|---|---|---|
| 1548779713 | Ryan Kirk Bingham | Dermatology | 2855 E Brown Rd Ste 22, Mesa, AZ 85213-4216 | 2017-09-20 |
| 1659829109 | Arizona Skin and Laser Therapy Institute, Ltd | Dermatology | 6644 E Baseline Rd, Mesa, AZ 85206-4438 | 2016-09-13 |
| 1659630713 | Robert Anderton | Dermatology | 4318 N Desert Oasis Cir, Mesa, AZ 85207-7246 | 2012-05-10 |
| 1962729160 | Chao Li | Dermatology | 6832 E Brown Rd, Mesa, AZ 85207 | 2010-04-27 |
| 1083841225 | Daniel Peterson Skinner Jr. | Dermatology | 2050 W Southern Ave Ste 102, Mesa, AZ 85202-4702 | 2009-06-15 |
| 1679685614 | Robert David Griego | Dermatology | 2250 W Southern, 102, Mesa, AZ 85202 | 2006-08-31 |
| 1770699134 | Zeena Irene Ubogy | Dermatology | 2150 S Dobson Road, Ste #1, Mesa, AZ 85202 | 2006-08-21 |
| 1053368134 | Alvin R. Fulkerson | Dermatology | 1242 E Mckellips Rd, Ste 103, Mesa, AZ 85203-2763 | 2006-05-27 |
| 1568416790 | Rcdc of Mesa Plc | Dermatology | 2158 N Gilbert Rd, Suite 121a, Mesa, AZ 85203-2109 | 2006-05-20 |
| 1851340467 | Jayshri Gamoth | Dermatology | 4540 E Baseline Rd Ste 109, Mesa, AZ 85206-4616 | 2006-05-09 |
| Find all providers in MESA | ||||
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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.