KRISTEN FORMAN MD INC (NPI# 1073950325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073950325 |
| Entity Type | Organization |
| Organization Name | KRISTEN FORMAN MD INC |
| Practice Address |
1617 Westcliff Dr 100 Newport Beach CA 92660-5524 |
| Practice Telephone | 9495154111 |
| Practice Fax Number | 9495150318 |
| Mailing Telephone | 9495154111 |
| Mailing Fax Number | 9495150318 |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2013-05-28 |
| Authorized Official Name | KRISTEN FORMAN (PRESIDENT) |
| Authorized Official Telephone | 9495154111 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians |
| Street Address |
1617 WESTCLIFF DR 100 |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92660-5524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578527131 | Douglas Roy Mest | Anesthesiology | 1617 Westcliff Dr, Newport Beach, CA 92660-5525 | 2006-04-12 |
| 1477014868 | Bruce B Lee, M.d. | Obstetrics & Gynecology | 1617 Westcliff Dr, Newport Beach, CA 92660-5524 | 2019-03-27 |
| 1578004743 | Terry Dubrow, M.d., A Medical Corporation | Surgery | 1617 Westcliff Dr, Suite 207, Newport Beach, CA 92660-5524 | 2017-03-20 |
| 1821469321 | Jacqueline Brambila | Physician Assistant | 1617 Westcliff Dr, Suite 207, Newport Beach, CA 92660-5524 | 2015-10-09 |
| 1598161937 | Healthcore Physical Therapy | Clinic/Center | 1617 Westcliff Dr, Suite 205, Newport Beach, CA 92660-5524 | 2014-11-12 |
| 1750719183 | Rox Surgery Center Newport Beach LLC | Clinic/Center | 1617 Westcliff Dr, 106, Newport Beach, CA 92660-5524 | 2013-10-22 |
| 1033464110 | Cynthia Chen Lazzaro | Dermatology | 1617 Westcliff Dr, Suite 100, Newport Beach, CA 92660-5524 | 2012-07-16 |
| 1740505395 | Moss Chiropractic & Nutrition Inc | Chiropractor | 1617 Westcliff Dr, Suite 202, Newport Beach, CA 92660-5524 | 2010-04-06 |
| 1174857023 | Ltc Dermatology | Dermatology | 1617 Westcliff Dr, #100, Newport Beach, CA 92660-5524 | 2009-09-24 |
| 1558514612 | Holly Beardsley | Physician Assistant | 1617 Westcliff Dr, Suite 100, Newport Beach, CA 92660-5524 | 2008-11-02 |
| Find all providers in the same location | ||||
| 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 | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013136357 | Integrated Dermatology and Dermatopathology, Inc. | Dermatology | 1525 Superior Ave, Suite 210, Newport Beach, CA 92663-3639 | 2007-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578175006 | Lms Medical Services | Dermatology | 1118 N Mccadden Pl, Los Angeles, CA 90038-1213 | 2020-08-17 |
| 1932687241 | Silhouette Medical Group | Dermatology | 101 E Vineyard Ave Ste 107, Livermore, CA 94550-6877 | 2018-07-31 |
| 1780188482 | California Dermatology Physicians | Dermatology | 1902 Fullerton Ave # 102, Corona, CA 92881-3112 | 2018-03-19 |
| 1942709738 | Azadeh Shirazi Md Inc | Dermatology | 7301 Girard Ave Ste 202, La Jolla, CA 92037-5151 | 2018-02-07 |
| 1205342920 | Solano Dermatology Associates Inc | Dermatology | 1700 2nd St Ste 220, Napa, CA 94559-2455 | 2017-12-18 |
| 1831603901 | Laser Medspa, Inc. | Dermatology | 73655 El Paseo Ste N, Palm Desert, CA 92260-4304 | 2017-11-27 |
| 1326427204 | Jennifer Herrmann Md Inc | Dermatology | 421 N Rodeo Dr Ste 7, Beverly Hills, CA 90210-4514 | 2015-05-25 |
| 1235540196 | Microsurgery Goup | Dermatology | 21039 S Figueroa Ave Suite 201, Carson, CA 90745-7042 | 2014-05-14 |
| 1811261183 | Robert Ray Nettles | Dermatology | 8500 Wilshire Blvd Ste 630, Beverly Hills, CA 90211-3139 | 2012-03-02 |
| 1164748737 | Jane Chung | Dermatology | 895 E Fremont Ave Ste 201, Sunnyvale, CA 94087-2973 | 2010-04-08 |
| Find all providers with the same taxonomy | ||||
| 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.