GEOVER FERNANDEZ (NPI# 1639103138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639103138 |
| Entity Type | Individual |
| Full Name | GEOVER FERNANDEZ |
| Credential | MD |
| Practice Address |
520 N Prospect Ave Suite 302 Redondo Beach CA 90277-3041 |
| Practice Telephone | 3107981515 |
| Practice Fax Number | 3107983131 |
| Mailing Telephone | 3107981515 |
| Mailing Fax Number | 3107983131 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2013-01-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | A103070 | CA | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
A103070 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE RAILROAD PTAN | P00980455 | 01 |
| Street Address |
520 N PROSPECT AVE SUITE 302 |
| City | REDONDO BEACH |
| State | CA |
| Zip Code | 90277-3041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699779660 | William James Wickwire | Dermatology | 520 N Prospect Ave, Ste 302, Redondo Beach, CA 90277-3043 | 2005-06-08 |
| 1265980437 | Nitin Bhakta | Pharmacist | 520 N Prospect Ave, Suite 110, Redondo Beach, CA 90277-3041 | 2016-09-16 |
| 1356799415 | A. R. I. Clinical Trials, Inc. | Clinic/Center | 520 N Prospect Ave, Suite 201, Redondo Beach, CA 90277-3041 | 2016-05-31 |
| 1962866483 | Jamie W Wu | Registered Nurse | 520 N Prospect Ave, Suite 203, Redondo Beach, CA 90277-3041 | 2016-04-11 |
| 1225463797 | Los Angeles Ent Facial Plastics Center, Inc | Clinic/Center | 520 N Prospect Ave, Suite 302, Redondo Beach, CA 90277-3041 | 2013-09-03 |
| 1053669390 | Brenda Shen | Family Medicine | 520 N Prospect Ave, Suite 103, Redondo Beach, CA 90277-3041 | 2012-08-16 |
| 1346536968 | Sitaraman Jyotheeswaran Md Facp A Medical Corporation | Internal Medicine | 520 N Prospect Ave, Suite # 304, Redondo Beach, CA 90277-3041 | 2011-06-22 |
| 1952617342 | Lewis Wong | Family Medicine | 520 N Prospect Ave, Redondo Beach, CA 90277-3041 | 2010-08-24 |
| 1942452453 | Michael S. Greiner | Chiropractor | 520 N Prospect Ave, Ste # 201, Redondo Beach, CA 90277-3041 | 2008-10-15 |
| 1164672796 | Melody Lee | Nurse Practitioner | 520 N Prospect Ave, Redondo Beach, CA 90277-3041 | 2008-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780215103 | Robert John Coffman | Psychologist | 316b North Pacific Coast Hwy., Redondo Beach, CA 90277 | 2020-02-04 |
| 1952949786 | Anne E Pitts | Dietitian, Registered | 360 The Village Drive Unit 207, Redondo Beach, CA 90277 | 2019-12-11 |
| 1558916841 | Dana Bryon Staub | Social Worker | 205 Ave. I, Suite 17, Redondo Beach, CA 90277 | 2019-08-05 |
| 1376033860 | Lisa Ann Graziano | Marriage & Family Therapist | 514 N. Prospect Avenue, Suite 111 Lower Level, Redondo Beach, CA 90277 | 2018-05-10 |
| 1275981326 | Carla Marie Vasquez | Marriage & Family Therapist | 901 N. Pacific Coast Highway, 200a, Redondo Beach, CA 90277 | 2016-05-31 |
| 1154793628 | Marianne M. Cuttic, Dpm, Inc | Podiatrist | 1970 S Prospect Avenue, Suite 4, Redondo Beach, CA 90277 | 2015-10-23 |
| 1841682994 | Mary Schopfel | Counselor | 901 Pacific Coast Highway, 200a, Redondo Beach, CA 90277 | 2015-02-26 |
| 1700287141 | Rose Ross | Marriage & Family Therapist | 901 North Pacific Coast Highway, Suite 200a, Redondo Beach, CA 90277 | 2014-09-04 |
| 1912307661 | Gale Hazeltine | Physical Therapist | 409 N PCh Hwy # 308, Redondo Beach, CA 90277 | 2014-08-31 |
| 1194135889 | Physical Therapy Concierge Service Inc | Clinic/Center | 704 N. Irena, B, Redondo Beach, CA 90277 | 2014-05-02 |
| Find all providers in zip 90277 | ||||
| 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/ |
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|---|---|---|---|---|
| 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 | REDONDO BEACH |
| Zip Code | 90277 |
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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.