DALE A KOOISTRA (NPI# 1831182971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1831182971 |
Entity Type | Individual |
Full Name | DALE A KOOISTRA |
Credential | M.D., PHD. |
Practice Address |
15525 Pomerado Rd Suite D2 Poway CA 92064-2435 |
Practice Telephone | 8586758001 |
Practice Fax Number | 8584871337 |
Mailing Telephone | 8586758001 |
Mailing Fax Number | 8584871337 |
Enumeration Date | 2005-08-24 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207N00000X | Dermatology | G55734 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 00G557340 | 05 |
Street Address |
15525 POMERADO RD SUITE D2 |
City | POWAY |
State | CA |
Zip Code | 92064-2435 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073519955 | Debra Joan Abel | Audiologist | 15525 Pomerado Rd, E-1, Poway, CA 92064-2435 | 2005-06-24 |
1619412806 | Waves, A Psychological Corporation | Psychologist | 15525 Pomerado Rd, Suite C-5, Poway, CA 92064-2435 | 2016-12-27 |
1083003586 | San Diego Psychological Center Inc. | Psychologist | 15525 Pomerado Rd, Suite B3, Poway, CA 92064-2435 | 2015-01-21 |
1871994905 | Tracy Daly | Dietitian, Registered | 15525 Pomerado Rd, Suite B-1, Poway, CA 92064-2435 | 2014-09-08 |
1144655507 | Blue Skies Behavioral Health | Clinic/Center | 15525 Pomerado Rd, Suite B-1, Poway, CA 92064-2435 | 2013-09-04 |
1295088334 | San Diego Diagnostic Radiology Medical Group, Inc. | Clinic/Center | 15525 Pomerado Rd, Suite E2, Poway, CA 92064-2435 | 2012-10-25 |
1598047086 | Sarah L Jacobs-paul | Counselor | 15525 Pomerado Rd, Suite C-5, Poway, CA 92064-2435 | 2011-09-12 |
1568750438 | Amanda Louise Peeler | Physical Therapist | 15525 Pomerado Rd, Ste D4, Poway, CA 92064-2435 | 2011-07-13 |
1952694408 | Erika Swift Holtermann | Psychologist | 15525 Pomerado Rd, Suite B-1, Poway, CA 92064-2435 | 2011-05-17 |
1124310917 | Cpte Physical Therapy Professional Corporation | Physical Therapist | 15525 Pomerado Rd, Ste D4, Poway, CA 92064-2435 | 2011-05-11 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194357384 | Prabha Choudhary | Student in an Organized Health Care Education/Training Program | 17555, Corte Lomas Verdes, Poway, CA 92064 | 2020-02-06 |
1770143968 | Theresa Marie Morales | In Home Supportive Care | 15352 Running Deer Trl, Poway, CA 92064 | 2019-06-19 |
1689230997 | Jaclyn Miller | Audiologist | Health Medical Group, 15525 Pomerado Road Suite C-1, Poway, CA 92064 | 2019-05-13 |
1205306842 | Angelita Fuentes | Behavior Technician | 12975 Brookprinter Place Suite 250, Poway, CA 92064 | 2018-11-27 |
1396235271 | Michael Cutler, M.d., P.C. | Clinic/Center | 12285 Scripps Poway Pkwy Ste 103, Poway, CA 92064 | 2018-05-16 |
1720576671 | Jodi A Mcgrady Dmd, Ms, Adc | Dentist | 12350 Oak Knoll Rd, Poway, CA 92064 | 2018-04-26 |
1295237139 | Michelle J. Beaupre | Social Worker | 204 Poway Rd., Poway, CA 92064 | 2018-03-07 |
1669918165 | Restore Detox Centers | Substance Abuse Rehabilitation Facility | 14099 Sky Mountain Trail, Poway, CA 92064 | 2017-01-09 |
1205382561 | Nightingale Meyou | Pharmacist | 5615 Pomerado Rd, Poway, CA 92064 | 2016-08-28 |
1578017232 | Elan Lee | Dentist | 13035 Pomerado Road Suite B, Poway, CA 92064 | 2016-08-11 |
Find all providers in zip 92064 |
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 |
---|---|---|---|---|
1518425966 | California Hair Extensions | Dermatology | 12759 Poway Rd Ste 101, Poway, CA 92064-4445 | 2019-03-05 |
1639550833 | Naomi Travers | Dermatology | 15725 Poway Road, Suite 102, Poway, CA 92064-5138 | 2015-06-12 |
1356608319 | Paul Chun-pu Jou | Dermatology | 15611 Pomerado Rd Ste 400, Poway, CA 92064-2437 | 2012-04-16 |
1366685737 | Park Terrace Medical Associates Inc | Dermatology | 15611 Pomerado Rd, Suite 400, Poway, CA 92064-2437 | 2009-04-14 |
1306096680 | Anne Kathleen Truitt | Dermatology | 15611 Pomerado Rd Ste 400, Poway, CA 92064-2437 | 2008-09-24 |
1376757625 | E. Stanley Rodier, M.d.,frcpc,inc | Dermatology | 15725 Pomerado Rd, Suite 108, Poway, CA 92064-2068 | 2007-05-09 |
1134201312 | Ernest Stanley Rodier, Frcpc,inc | Dermatology | 15725 Pomerado Road, Suite 108, Poway, CA 92064 | 2006-10-19 |
1912973868 | Stephen Wells Shewmake | Dermatology | 15611 Pomerado Rd, Poway, CA 92064-2437 | 2006-02-28 |
1992786347 | Diane M Scott | Dermatology | 15611 Pomerado Rd, Suite 400, Poway, CA 92064-2437 | 2005-11-10 |
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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 |
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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.