DR. SANDRA STEPHANIE MORIMOTO (NPI# 1114059623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114059623 |
| Entity Type | Individual |
| Full Name | DR. SANDRA STEPHANIE MORIMOTO |
| Credential | M.D. |
| Practice Address |
13625 Glencliff Way San Diego CA 92130-1324 |
| Practice Telephone | 6198469340 |
| Mailing Telephone | 6198469340 |
| Enumeration Date | 2007-03-10 |
| Last Update Date | 2016-02-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
G49685 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
13625 GLENCLIFF WAY |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92130-1324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629692397 | Tlc Family Therapy | Marriage & Family Therapist | 5965 Village Way. Suite 105 #112, San Diego, CA 92130 | 2020-05-29 |
| 1447746169 | Jack Perlov | Psychiatry & Neurology | 3535 Caminito El Rincon, Unit 268, San Diego, CA 92130 | 2018-07-05 |
| 1326551003 | Theotokos, LLC | Pharmacy | 5550 Carmel Mountain Rd Ste 111, San Diego, CA 92130 | 2017-11-16 |
| 1154879146 | Halie Hommes | Occupational Therapist | 12250 El Camino Real Ste 250, San Diego, CA 92130 | 2016-09-19 |
| 1790232015 | Coastal Skin and Eye Institute, Inc. | Ophthalmology | 5550 Carmel Mountain Road, Suite 206, San Diego, CA 92130 | 2016-09-02 |
| 1720534951 | Nosti and Rygg Dental Corporation | Dentist | 5550 Carmel Mountain Road, Ste 200, San Diego, CA 92130 | 2016-08-28 |
| 1831644053 | Marco Savittieri | Dentist | 3715 Ruette De Vl, San Diego, CA 92130 | 2016-08-17 |
| 1336508621 | Discovery Practice Management, Inc | Psychiatric Residential Treatment Facility | 11455 Camino Real, Ste 360, San Diego, CA 92130 | 2016-02-16 |
| 1427434679 | Coast Pediatrics Carmel Valley | Pediatrics | 5965 Village Drive, Suite 201, San Diego, CA 92130 | 2015-08-10 |
| 1659753762 | T Sidal Dds Md Inc | Dentist | 12395 El Camino Real, Suite 304, Torrey Pines Oral & Maxillofacial Surgery, San Diego, CA 92130 | 2015-06-25 |
| Find all providers in zip 92130 | ||||
| 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 |
|---|---|---|---|---|
| 1467421917 | William P Mansfield | Dermatology | 406 9th Ave, Suite 201, San Diego, CA 92101-7276 | 2006-03-16 |
| 1285961623 | Douglas M Keel Do Inc | Dermatology | 8899 University Center Ln, Suite 150, San Diego, CA 92122-1013 | 2009-11-05 |
| 1205090826 | Salman M S Alsaad | Dermatology | 3811 Valley Centre Dr, San Diego, CA 92130-3318 | 2008-07-13 |
| 1760522080 | Kimberly Jane Butterwick | Dermatology | 9339 Genesee Ave, 300, San Diego, CA 92121-2119 | 2007-02-07 |
| 1538240833 | Mitchel Paul Goldman | Dermatology | 9339 Genesee Ave, 300, San Diego, CA 92121-2119 | 2006-10-17 |
| 1982682852 | Peter Randall Shumaker | Dermatology | Naval Medical Ctr, 34800 Bob Wilson Dr., Ste 300, San Diego, CA 92134-0001 | 2006-01-02 |
| 1154320075 | Douglas Michael Keel | Dermatology | 8899 University Center Ln, Suite 150, San Diego, CA 92122-1013 | 2005-07-21 |
| 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 | ||||
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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.