EAST BAY DERMATOLOGY MEDICAL GROUP INC (NPI# 1447220215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447220215 |
| Entity Type | Organization |
| Organization Name | EAST BAY DERMATOLOGY MEDICAL GROUP INC |
| Other Organization Name | CENTER FOR DERMATOLOGY COSMETIC & LASER SURGERY |
| Practice Address |
2557 Mowry Ave Ste 34 and Ste 25 Fremont CA 94538 |
| Mailing Address |
2557 Mowry Ave Ste 34 Fremont CA 94538 |
| Practice Telephone | 5107974111 |
| Practice Fax Number | 5107973320 |
| Mailing Telephone | 5107974111 |
| Mailing Fax Number | 5107973320 |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JEFFREY A CARMEL (CEO) |
| Authorized Official Telephone | 5107974111 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Center for Dermatology Cosmetic & Laser Surgery | Doing Business As Name - Organization |
| Street Address |
2557 MOWRY AVE STE 34 AND STE 25 |
| City | FREMONT |
| State | CA |
| Zip Code | 94538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316498421 | Pansmart Inc | Pharmacy | 2557 Mowry Ave, Suite # 11, Fremont, CA 94538-1603 | 2016-10-24 |
| 1629490362 | Olivia Danielle Martinez | Nurse Practitioner | 2557 Mowry Ave, Suite 25, Fremont, CA 94538-1603 | 2014-01-15 |
| 1518251701 | Harman Chawla | Internal Medicine | 2557 Mowry Ave, Suite 12, Fremont, CA 94538-1603 | 2011-06-05 |
| 1730345869 | Kalindi Oza | Audiologist | 2557 Mowry Ave, Suite 30, Fremont, CA 94538-1603 | 2008-07-29 |
| 1265598866 | Iraj Dulabi Zandi | Specialist | 2557 Mowry Ave, Suite 20, Fremont, CA 94538-1603 | 2006-12-28 |
| 1952464943 | Fremont Eat Nose & Throat Med Group Inc | Otolaryngology | 2557 Mowry Ave, #30, Fremont, CA 94538 | 2006-12-19 |
| 1477662039 | Arun Srivatsa | Internal Medicine | 2557 Mowry Ave, Suite 12, Fremont, CA 94538-1603 | 2006-08-29 |
| 1972521060 | Jason Chu | Internal Medicine | 2557 Mowry Ave, Suite 12, Fremont, CA 94538-1603 | 2006-07-17 |
| 1457379554 | Marco Pavesi | Internal Medicine | 2557 Mowry Ave, Suite 12, Fremont, CA 94538-1603 | 2006-07-17 |
| 1962428896 | Muni Michael Barash | Internal Medicine | 2557 Mowry Ave, Suite 12, Fremont, CA 94538-1603 | 2006-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699394460 | Bay Area Kidney Care Medical Group Inc. | Clinic/Center | 39370 Mozart Terrace Unit 106, Fremont, CA 94538 | 2020-04-13 |
| 1740847284 | Gloria Ann Federico | Behavior Technician | 39210 State St., Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2019-05-21 |
| 1093270688 | Timothy Lorne Haynes | Chiropractor | 3775 Beacon Ave., Suite 200, Fremont, CA 94538 | 2019-02-07 |
| 1902370067 | Nicole Sandoval | Counselor | 39155 Liberty St Suite E500, Fremont, CA 94538 | 2019-01-11 |
| 1497225015 | Megan Galban | Behavior Technician | 39210 State St. Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1780154302 | Karla Patricia Plascencia | Behavior Technician | 39210 State Street Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1215407846 | Sydney J Torrens | Behavior Technician | 39210 State St. Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2018-11-27 |
| 1932676277 | Jarah Harvan | Psychologist | 1999 Mowry Ave Ste F, Fremont, CA 94538 | 2018-10-24 |
| 1205321965 | Chien Shien Yang Md Inc | Psychiatry & Neurology | 1860 Mowry Ave Ste 301a, Fremont, CA 94538 | 2018-06-26 |
| 1912416199 | Advanced Interventional Surgical Center | Clinic/Center | 3077 Stevenson Blvd, Fremont, CA 94538 | 2017-09-20 |
| Find all providers in zip 94538 | ||||
| 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 |
|---|---|---|---|---|
| 1811550197 | Mallory Ann Hoskins | Dermatology | 410 E 22nd St, Fremont, NE 68025-2639 | 2019-04-22 |
| 1801277801 | Skin PC | Dermatology | 1935 E Military Ave, Fremont, NE 68025-5489 | 2015-06-15 |
| 1124351051 | Nilanthi Gunawardane | Dermatology | 39400 Paseo Padre Pkwy, Fremont, CA 94538-2310 | 2009-09-10 |
| 1043386527 | Rebecca L. Shpall | Dermatology | 3200 Kearney Street, Fremont, CA 94538-2299 | 2006-11-28 |
| 1386729044 | Stephen B. Martinez | Dermatology | 39400 Paseo Padre Pkwy, Fremont, CA 94538-2310 | 2006-10-25 |
| 1508941279 | Akhil Wadhera | Dermatology | 39400 Paseo Padre Pkwy, Fremont, CA 94538-2310 | 2006-10-25 |
| 1215012976 | Stephanie Friduss | Dermatology | 39400 Paseo Padre Pkwy, Fremont, CA 94538-2310 | 2006-10-25 |
| 1851476527 | Tracie B. Tavel | Dermatology | 39400 Paseo Padre Pkwy, Fremont, CA 94538-2310 | 2006-10-25 |
| 1841386489 | Tatiana Grzeszkiewicz | Dermatology | 3200 Kearney St, Palo Alto Medical Foundation Dermatology, Fremont, CA 94538-2299 | 2006-10-04 |
| 1629032271 | Matthew Harrison Kanzler | Dermatology | 3200 Kearney Street, Dermatology Department, Fremont, CA 94538-2299 | 2006-04-12 |
| Find all providers in FREMONT | ||||
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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.