KELLY BICKLE MD INC (NPI# 1255845657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255845657 |
| Entity Type | Organization |
| Organization Name | KELLY BICKLE MD INC |
| Other Organization Name | KELLY BICKLE, MD |
| Practice Address |
1244 7th St Ste 204 Santa Monica CA 90401-1648 |
| Practice Telephone | 3108784590 |
| Practice Fax Number | 4242143301 |
| Mailing Telephone | 3108784590 |
| Mailing Fax Number | 4242143301 |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-11-21 |
| Authorized Official Name | KELLY BICKLE (OWNER) |
| Authorized Official Telephone | 3108784590 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
A95166 | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| KELLY BICKLE, MD | Doing Business As Name - Organization |
| Street Address |
1244 7TH ST STE 204 |
| City | SANTA MONICA |
| State | CA |
| Zip Code | 90401-1648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598296980 | Jessica Ann Jones | Dental Hygienist | 1244 7th St Ste 204, Santa Monica, CA 90401-1648 | 2017-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013499458 | Franchesca Johnson Gordon | Marriage & Family Therapist | 900 Wilshire Blvd., Ste. 450, Santa Monica, CA 90401 | 2018-09-01 |
| 1629564083 | Michelle Jillian Dolinsky | Social Worker | 1243 7th St Ste C, Santa Monica, CA 90401 | 2018-07-09 |
| 1528507084 | Doctor Tlc, License Clinical Psychologist, Inc. | Community/Behavioral Health | 1242 Third St Promenade, Suite 208, Santa Monica, CA 90401 | 2017-02-16 |
| 1285006023 | Venessa Leeann Roca | Speech-Language Pathologist | 1218 6th Street, Santa Monica, CA 90401 | 2015-10-20 |
| 1720468036 | Stephen J. Kenneally | Marriage & Family Therapist | 610 Santa Monica Bvd, Ste. 201, Santa Monica, CA 90401 | 2015-06-02 |
| 1629458070 | Dominique L Robertson | Marriage & Family Therapist | 530 Wilshire, #310, Santa Monica, CA 90401 | 2015-06-01 |
| 1205252673 | Santa Monica Sports Medicine Inc. | Physical Medicine & Rehabilitation | 900 Wilshire Blvd. #410, Santa Monica, CA 90401 | 2014-03-10 |
| 1154675023 | Sherry Marie Martyn | Psychologist | 1242 3rd Street Promenade Ste 208, Santa Monica, CA 90401 | 2012-10-31 |
| 1700159829 | Gary Warburton | Dentist | 519 Arizona Ave., Santa Monica, CA 90401 | 2012-02-21 |
| 1265713036 | Aleksandr Mailyan | Reflexologist | 201 Wilshire Blvd #101, Santa Monica, CA 90401 | 2011-09-07 |
| Find all providers in zip 90401 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174700702 | Ralph A Massey Md Inc | Dermatology | 1260 15th St, Ste 1401, Santa Monica, CA 90404 | 2008-01-25 |
| 1114112711 | Marc D. Chalet, Md, Inc. | Dermatology | 2811 Wilshire Blvd, Suite 615, Santa Monica, CA 90403-4803 | 2007-09-07 |
| 1326166521 | Lawrence Harry Matt | Dermatology | 1450 10th St, Suite 202, Santa Monica, CA 90401-2857 | 2007-03-26 |
| 1437238839 | Ronald J. Hale | Dermatology | 2811 Wilshire Blvd Ste 810, Santa Monica, CA 90403 | 2006-11-04 |
| 1780613588 | Marc David Chalet | Dermatology | 2811 Wilshire Blvd, Suite 615, Santa Monica, CA 90403-4803 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235792219 | Horizon Dermatology and Laser Institute | Dermatology | 369 San Miguel Dr. Suite 200, Newport Beach, CA 92660 | 2019-04-16 |
| 1487011995 | Brouha Dermatology, P.C. | Dermatology | 1319 Beryl St, San Diego, CA 92109-2102 | 2016-01-28 |
| 1528317419 | Heidi M Gilchrist, Md, Inc. | Dermatology | 345 Saxony Road Suite 201, Encinitas, CA 92024-2787 | 2012-09-06 |
| 1194028233 | Pavillion Asc Inc. | Dermatology | 28901 S. Western Avenue #127, Rancho Palos Veredes, CA 90275 | 2010-12-13 |
| 1093021495 | Douglas G Hamilton Medical Corp | Dermatology | 6325 Topanga Canyon Blvd Ste 301, Woodland Hills, CA 91367-2029 | 2010-08-23 |
| 1124254933 | Ronnie M Abraham | Dermatology | 3440 Empresa Dr Ste B, San Luis Obispo, CA 93401 | 2009-06-08 |
| 1316187180 | Choice Telemed | Dermatology | 2001 Union St Ste 495, San Francisco, CA 94123-4128 | 2009-03-05 |
| 1063686707 | James D. Jacobitz, M.d. Inc. | Dermatology | 190 Eucalyptus Dr, San Francisco, CA 94132-1629 | 2008-04-14 |
| 1407034481 | Richard P Klimkowski Md PC | Dermatology | 224 Del Mar, #b, San Clemente, CA 92672-4011 | 2008-02-01 |
| 1457538415 | S. Gayle Widyolar, M.d., Inc. | Dermatology | 21 Montecito Dr, Corona Del Mar, CA 92625-1017 | 2008-01-22 |
| Find all providers with the same taxonomy | ||||
| City | SANTA MONICA |
| Zip Code | 90401 |
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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.