GREGORY PHILIP HENDERSON (NPI# 1619109519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619109519 |
Entity Type | Individual |
Full Name | GREGORY PHILIP HENDERSON |
Credential | M.D. |
Practice Address |
1441 Avocado Ave Ste 409 Newport Beach CA 92660-7705 |
Practice Telephone | 9496404501 |
Mailing Telephone | 9496404501 |
Enumeration Date | 2009-08-11 |
Last Update Date | 2020-06-18 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207N00000X | Dermatology | A125261 | CA | Allopathic & Osteopathic Physicians |
Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
A125261 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | ENROLLED | 05 | |
IA | ENROLLED | 05 | |
MN | RAILROAD MEDICARE | P00940083 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
1360 W 6th St Ste 270, San Pedro, CA 907323539 | 3108311272 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003247958 | Gregory Henderson | Counselor | 39 Fogg Farm Road, Wilder, VT 05088 | 2013-12-03 |
1417206251 | Gregory Henderson | Counselor | 725 Highland Ave Unit 100, Winston Salem, NC 27101-4181 | 2012-09-07 |
1679873459 | Gregory Joseph Henderson | Acupuncturist | 1 Liberty Ave, Jeffersonville, PA 19403-3105 | 2010-10-27 |
1447571633 | Gregory Shannon Henderson | Psychiatry & Neurology | 620 John Paul Jones Cir, Portsmouth, VA 23708-2197 | 2010-06-22 |
1982826509 | Gregory A Henderson | Social Worker | 40 Camelot Drive, Fond Du Lac, WI 54935 | 2007-05-03 |
1942230701 | Gregory H Henderson | Anesthesiology | 1701 Senate Blvd, Indianapolis, IN 46202-1239 | 2006-07-04 |
1528004298 | Gregory Henderson | Occupational Therapist | 3700 N Capitol St Nw, Washington, DC 20011-8400 | 2006-06-21 |
1407804859 | Gregory S Henderson | Pathology | 2520 Cherry Ave, Pathology Department, Bremerton, WA 98310-4229 | 2006-05-05 |
1528068335 | Gregory D Henderson | Nurse Anesthetist, Certified Registered | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2005-07-22 |
1427055227 | Gregory L Henderson Sr. | Ophthalmology | 403 Vonderburg Dr, Ste 101, Brandon, FL 33511-5982 | 2005-07-07 |
Street Address |
1441 AVOCADO AVE STE 409 |
City | NEWPORT BEACH |
State | CA |
Zip Code | 92660-7705 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164596755 | Jeanne M. Spudick, D.o., A Medical Corporation | Internal Medicine | 1441 Avocado Ave Ste 409, Newport Beach, CA 92660-7705 | 2006-11-17 |
1710186085 | David C. Herzlinger,m.d.,a Professional Corp | Specialist | 1441 Avocado Ave Ste 409, Newport Beach, CA 92660-7705 | 2007-07-16 |
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 | 207ND0101X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
Specialization | MOHS-Micrographic Surgery |
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740410182 | Pacific Dermatology Institute | Dermatology | 240 Newport Center Dr Ste 105, Suite 105, Newport Beach, CA 92660 | 2009-07-20 |
1689711244 | Advanced Skincare Medcenter Inc. | Dermatology | 369 San Miguel Dr Ste 235, Newport Beach, CA 92660-7816 | 2007-01-31 |
1477564128 | Grace S Liu | Dermatology | 3991 Macarthur Blvd, Suite 228, Newport Beach, CA 92660-3058 | 2006-08-10 |
1700035946 | Adam M. Rotunda, M.d., A Professional Corporation | Dermatology | 1100 Quail St, Suite 102, Newport Beach, CA 92660-2701 | 2008-09-11 |
1861656563 | Grace Liu, Md Inc. | Dermatology | 3991 Macarthur Blvd, Ste. 228, Newport Beach, CA 92660-3009 | 2008-07-11 |
1255590808 | Gregory Alan. Bartlow, M.d., Inc. | Dermatology | 1441 Avocado Ave, 806, Newport Beach, CA 92660-7721 | 2008-06-07 |
1063608107 | Newport Coast Dermatology | Dermatology | 3991 Macarthur Blvd, Suite 228, Newport Beach, CA 92660-3058 | 2007-09-21 |
1124166400 | Dermatology & Laser Clinic, Inc. | Dermatology | 401 Old Newport Blvd, Suite 102, Newport Beach, CA 92663-4269 | 2007-02-01 |
1497706113 | Tanya Jeanette Foreman | Dermatology | 400 Newport Center Dr, Suite 702, Newport Beach, CA 92660-7601 | 2006-05-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578173936 | Mill Valley Dermatology, Inc | Dermatology | 655 Redwood Hwy Frontage Rd Ste 100, Mill Valley, CA 94941-3031 | 2020-07-31 |
1710508874 | Zhe Hou, M.d., Ph.d., A Professional Corporation | Dermatology | 3000 E Imperial Hwy Ste 150, Brea, CA 92821-6782 | 2020-04-29 |
1073152112 | Agape Dermatology PC | Dermatology | 18800 Main St Ste 111, Huntington Beach, CA 92648-1717 | 2020-01-06 |
1497392492 | Pacifica Dermatology | Dermatology | 2460 N Ponderosa Dr Ste A117, Camarillo, CA 93010-2468 | 2019-12-09 |
1518447689 | Razieh Soltani Arabshahi Md Inc | Dermatology | 960 E Green St Ste 330, Pasadena, CA 91106-2401 | 2018-08-18 |
1811497928 | Laca Dermatology, Inc | Dermatology | 4955 Van Nuys Blvd Ste 516, Sherman Oaks, CA 91403-1832 | 2018-02-15 |
1427509959 | Northern California Medical Assoc Inc | Dermatology | 555 S Dora St Ste B, Ukiah, CA 95482-5424 | 2016-10-19 |
1376091553 | Integrated Dermatology of Mission Viejo, Apmc | Dermatology | 26691 Plaza Ste 230, Mission Viejo, CA 92691-6300 | 2016-09-15 |
1164835518 | Laila Elkeeb, M.d., Inc | Dermatology | 242 Wicker, Irvine, CA 92618-1170 | 2014-06-03 |
1518303924 | Christine Shaver | Dermatology | 1301 20th St Ste 570, Santa Monica, CA 90404-2118 | 2013-05-13 |
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.