PACIFIC DERMATOLOGY INSTITUTE (NPI# 1922486117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922486117 |
| Entity Type | Organization |
| Organization Name | PACIFIC DERMATOLOGY INSTITUTE |
| Practice Address |
240 Newport Center Dr Suite 105 Newport Beach CA 92660-7512 |
| Practice Telephone | 9466442450 |
| Practice Fax Number | 9466442451 |
| Mailing Telephone | 9466442450 |
| Mailing Fax Number | 9466442451 |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2015-05-08 |
| Authorized Official Name | MR. JEFFREY BOTTOMLEY (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 9093622966 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | A79221 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740410182 | Pacific Dermatology Institute | Dermatology | 240 Newport Center Dr Ste 105, Suite 105, Newport Beach, CA 92660 | 2009-07-20 |
| Street Address |
240 NEWPORT CENTER DR SUITE 105 |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92660-7512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598791923 | Orange Coast Surgical Center, Inc | Clinic/Center | 240 Newport Center Dr, # 105, Newport Beach, CA 92660-7512 | 2006-06-25 |
| 1548324791 | Bradley Mudge Md Inc | Plastic Surgery | 240 Newport Center Dr, Suite 105, Newport Beach, CA 92660-7512 | 2006-12-21 |
| 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 |
| 1205445798 | Felecia A Pedrogo | Marriage & Family Therapist | 5020 Campus Street, Newport Beach, CA 92660 | 2020-07-30 |
| 1649898388 | Polyviou Dental Corportation, Inc. | Clinic/Center | 120 Newport Beach Drive, Suite 27, Newport Beach, CA 92660 | 2020-07-09 |
| 1154974525 | Jan M. Eckermann, Md Inc. | Neurological Surgery | 1617 W Cliff Dr, Ste 203, Newport Beach, CA 92660 | 2019-07-24 |
| 1235792219 | Horizon Dermatology and Laser Institute | Dermatology | 369 San Miguel Dr. Suite 200, Newport Beach, CA 92660 | 2019-04-16 |
| 1902366925 | Yasmine Central Gohar | Marriage & Family Therapist | 20271 Sw Birch St Ste 200, Newport Beach, CA 92660 | 2019-03-25 |
| 1245703255 | Charison Counseling | Counselor | 4000 Macarthur Bvd Suite 600 East Tower, Newport Beach, CA 92660 | 2019-01-03 |
| 1134698996 | Amber Werner | Chiropractor | 4029 Westerly Place, Suite #115, Newport Beach, CA 92660 | 2018-11-21 |
| 1861969008 | Healthy Me Oc | Dietitian, Registered | 4569 Macarthur Court, Suite 1100, Newport Beach, CA 92660 | 2018-10-25 |
| 1174015192 | Edwin Enwia | Clinic/Center | 1000 Bristol St N Ste 1b, Newport Beach, CA 92660 | 2018-06-05 |
| Find all providers in zip 92660 | ||||
| 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 |
|---|---|---|---|---|
| 1275144024 | Lumins Aesthetic and Wellness, Inc | Dermatology | 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 | 2020-08-14 |
| 1588917934 | Michael Patrick O'brien | Dermatology | 623 Via Lido Nord, Newport Beach, CA 92663-5549 | 2012-10-23 |
| 1457614919 | Donna Tran | Dermatology | 495 Old Newport Blvd Ste 200, Newport Beach, CA 92663-4204 | 2012-06-20 |
| 1902171341 | Dana Lee-anne Ellis | Dermatology | 400 Newport Center Dr Ste 702, Newport Beach, CA 92660-7669 | 2012-03-19 |
| 1417228644 | Monica Bonakdar | Dermatology | 20321 Irvine Ave Ste F3, Newport Beach, CA 92660-0269 | 2012-01-19 |
| 1447531017 | Samreen Choudhry | Dermatology | 1617 Westcliff Dr Ste 214, Newport Beach, CA 92660 | 2011-09-08 |
| 1578736724 | Kevin Tate Belasco | Dermatology | 1501 Superior Ave Ste 115, Newport Beach, CA 92663-3606 | 2008-04-09 |
| 1679769954 | Zenovia Hatziris Gabriel | Dermatology | 359 San Miguel Dr Ste 300, Newport Beach, CA 92660-7809 | 2007-09-19 |
| 1336278720 | Kay Keeyeul Sung | Dermatology | 1525 Superior Ave Ste 210, Newport Beach, CA 92663-3656 | 2007-03-03 |
| 1932283561 | Donna Marie West | Dermatology | 5140 Birch St, Ste #100, Newport Beach, CA 92660-2169 | 2006-10-24 |
| Find all providers in NEWPORT BEACH | ||||
| City | NEWPORT BEACH |
| Zip Code | 92660 |
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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.