DELMAR DERMATOLOGY CENTER (NPI# 1669575551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669575551 |
| Entity Type | Organization |
| Organization Name | DELMAR DERMATOLOGY CENTER |
| Practice Address |
12395 El Camino Real Suite #115 San Diego CA 92130 |
| Mailing Address |
Po Box 15807 Beverly Hills CA 90209-1807 |
| Practice Telephone | 8582599858 |
| Mailing Telephone | 9098607600 |
| Mailing Fax Number | 9098602757 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GLENN N LEDESMA (OWNER) |
| Authorized Official Telephone | 9098607600 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
12395 EL CAMINO REAL SUITE #115 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92130 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114541463 | Serena Mink | Specialist | 100 Park Plz Apt 407, San Diego, CA 92101-6710 | 2020-06-02 |
| 1023648201 | Pamela Renea Crane | Specialist | 3237 Meade Ave, San Diego, CA 92116-4519 | 2020-01-16 |
| 1184199853 | Oliver Rakeem Taylor | Specialist | 1265 Angelus Ave, San Diego, CA 92114-3108 | 2018-10-09 |
| 1376040923 | Mark Edmond Rierson | Specialist | 2333 1st Ave Ste 106, San Diego, CA 92101-1538 | 2018-04-10 |
| 1790232635 | Cristina Zheng-castruita | Specialist | 9308 Babauta Rd, Apt. 62, San Diego, CA 92129-4922 | 2016-09-08 |
| 1689027955 | Neelam Agashe | Specialist | 3445 Lebon Dr Apt 1215, San Diego, CA 92122-5267 | 2016-07-21 |
| 1376998864 | Briniti Ichull | Specialist | 3941 Kurtz St, San Diego, CA 92110 | 2016-05-03 |
| 1952765935 | Jacqueline Morgan | Specialist | 9625 Black Mountain Rd Ste 300, San Diego, CA 92126-4598 | 2016-04-06 |
| 1710341862 | Comprehensive Medical Reporting Services | Specialist | 9040 Friars Rd., Ste. 410, San Diego, CA 92108 | 2016-04-05 |
| 1790150555 | Mahmood Nazari | Specialist | 6209 Lake Apopka Pl, 6209 Lake Apopka Place, San Diego, CA 92119-3520 | 2015-12-04 |
| Find all providers in SAN DIEGO | ||||
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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.