KEITH CAMERON CARLSON (NPI# 1093749640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093749640 |
| Entity Type | Individual |
| Full Name | KEITH CAMERON CARLSON |
| Credential | MD |
| Practice Address |
200 Medical Plaza #450 Los Angeles CA 90095 |
| Mailing Address |
11511 Ne 10th St Bellevue Medical Center Bellevue WA 98004 |
| Practice Telephone | 3108250631 |
| Mailing Telephone | 4255023000 |
| Mailing Fax Number | 4255023589 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2017-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MD60650552 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL PPIN # | 00G501320 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679548879 | Keith Harold Carlson | Ophthalmology | 710 E 24th St Ste 205, Minneapolis, MN 55404-3810 | 2006-02-21 |
| 1427699230 | Keith Carlson | Nurse Anesthetist, Certified Registered | 400 W Mineral King Ave, Visalia, CA 93291-6237 | 2019-10-02 |
| Street Address |
200 MEDICAL PLAZA #450 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235107566 | The Regents of The University of California | Internal Medicine | 200 Medical Plaza, Suite 365,530,420,250,120,214, Los Angeles, CA 90095-0001 | 2006-03-11 |
| 1497355366 | Adrienne Elaine Bawa | Registered Nurse | 200 Medical Plaza, Los Angeles, CA 90095-0001 | 2020-10-29 |
| 1164912267 | Alice K Lee | Nurse Practitioner | 200 Medical Plaza, Los Angeles, CA 90095-0001 | 2018-05-14 |
| 1295239895 | James Michael Weinberger | Student in an Organized Health Care Education/Training Program | 200 Medical Plaza, Los Angeles, CA 90095-0001 | 2018-03-20 |
| 1215478847 | Anahita Moshfegh | Audiologist | 200 Medical Plaza, Los Angeles, CA 90095-7006 | 2017-03-15 |
| 1518386796 | Donald Elmore Dietz Iv | Internal Medicine | 200 Medical Plaza, Suite 365,420,120, Los Angeles, CA 90045-5631 | 2014-04-15 |
| 1760825590 | Connie Huey Lin | Allergy & Immunology | 200 Medical Plaza, # 365, 420, 120, Los Angeles, CA 90024-0001 | 2013-04-11 |
| 1447593645 | Yue Ma | Otolaryngology | 200 Medical Plaza, Ste 550, Los Angeles, CA 90024-0000 | 2013-04-05 |
| 1295098283 | Ingrid Edshteyn | Preventive Medicine | 200 Medical Plaza, Sutie 365,420,120, Los Angeles, CA 90024-0001 | 2012-06-24 |
| 1346506920 | Andrew Mehrdad Vahabzadeh-hagh | Otolaryngology | 200 Medical Plaza, Suite 550, Los Angeles, CA 90024-0000 | 2012-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982212155 | Alexandra Gubin | Social Worker | Ucla, 757 Westwood Medical Plaza, Los Angeles, CA 90095 | 2020-07-14 |
| 1952926263 | Georgina Parra | Student in an Organized Health Care Education/Training Program | 10833 Le Conteave, Los Angeles, CA 90095 | 2020-06-11 |
| 1609403575 | Yagmur Muftuoglu | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Neurosurgery, Los Angeles, CA 90095 | 2020-03-23 |
| 1619438173 | Brandon Covington Smith | Student in an Organized Health Care Education/Training Program | 727 Westwood Plaza, Dept of Internal Medicine, Los Angeles, CA 90095 | 2019-03-27 |
| 1184184913 | Alexander Daniel Yuen | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza (internal Medicine), Los Angeles, CA 90095 | 2019-03-19 |
| 1790266369 | Dana Saifan | Student in an Organized Health Care Education/Training Program | 1000 Veteran Avenue, Los Angeles, CA 90095 | 2018-08-22 |
| 1427549146 | Courtney Renee' Real | Registered Nurse | 757 Westwood Plz Ste 6236, Los Angeles, CA 90095 | 2018-05-29 |
| 1932605094 | Akash Atul Shah | Student in an Organized Health Care Education/Training Program | Ucla Department of Orthopaedic Surgery, 10833 Le Conte Avenue, 76-116 Chs, Los Angeles, CA 90095 | 2018-04-05 |
| 1316443435 | Dane Jensen Brodke | Orthopaedic Surgery | 757 Westwood Plaza, (orthopaedic Surgery), Los Angeles, CA 90095 | 2018-04-05 |
| 1477058824 | Thomas William Gaither Castellanos | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Urology, Los Angeles, CA 90095 | 2018-03-28 |
| Find all providers in zip 90095 | ||||
| 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 |
|---|---|---|---|---|
| 1669081204 | Lucy Boyadzhian | Dermatology | 7472 Melrose Ave, Los Angeles, CA 90046-7524 | 2020-07-29 |
| 1245862101 | Yuval Bibi, A Professional Corporation | Dermatology | 7266 Franklin Ave Apt 321, Los Angeles, CA 90046-8324 | 2020-02-09 |
| 1679120422 | Sameer Bashey Md Pllc | Dermatology | 9201 W Sunset Blvd Ste 414, Los Angeles, CA 90069-3705 | 2019-08-26 |
| 1538640669 | James Y. Wang, Md, Inc. | Dermatology | 888 S Figueroa St Ste 1050, Los Angeles, CA 90017-5310 | 2018-08-27 |
| 1235639691 | Pearl E. Grimes Md, Inc. | Dermatology | 5670 Wilshire Blvd Ste 650, Los Angeles, CA 90036-5609 | 2018-02-12 |
| 1578926622 | Tuyet Ann Nguyen | Dermatology | 1127 Wilshire Blvd Ste 600, Los Angeles, CA 90017-3907 | 2016-04-05 |
| 1215370960 | Courtney Phillips | Dermatology | 1200 N State St # 3250, Los Angeles, CA 90033-1029 | 2013-04-12 |
| 1760749311 | Ardalan Minokadeh | Dermatology | 9201 W Sunset Blvd Ste 602, Los Angeles, CA 90069-3707 | 2012-04-20 |
| 1518254481 | Samuel Jackson Balin | Dermatology | 200 Medical Plz Ste 450, Los Angeles, CA 90095 | 2011-06-29 |
| 1689963340 | Consuelo Veronica David | Dermatology | 3520 Somerset Dr, Los Angeles, CA 90016-4808 | 2011-04-04 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90095 |
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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.