RANDY JACOBS DERMATOLOGY INC. (NPI# 1699872630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699872630 |
| Entity Type | Organization |
| Organization Name | RANDY JACOBS DERMATOLOGY INC. |
| Practice Address |
27640 Encanto Dr # B Sun City CA 92586-3304 |
| Mailing Address |
23905 Clinton Keith Rd 114 Wildomar CA 92595-7899 |
| Practice Telephone | 9516727673 |
| Practice Fax Number | 9516721197 |
| Mailing Telephone | 9516727673 |
| Mailing Fax Number | 9516721197 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-03-12 |
| Authorized Official Name | MRS. TAMMY S BOLON (OFFICE MANAGER) |
| Authorized Official Telephone | 9516727673 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | A049395 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
27640 ENCANTO DR # B |
| City | SUN CITY |
| State | CA |
| Zip Code | 92586-3304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710082235 | Robert Phillips | Physician Assistant | 27640 Encanto Dr, Suite B, Sun City, CA 92586-4542 | 2006-09-13 |
| 1932204351 | Donna Hastert | Physician Assistant | 27640 Encanto Dr, Suite B, Sun City, CA 92586-4542 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053586800 | Binoy Govindbhai Patel | Physical Therapist | 29798 Haun Rd Ste 201, Menifee, CA 92586 | 2008-04-23 |
| 1164552667 | Diana Suzanne Koenen | Marriage & Family Therapist | Sun Plaza Business Center, 27851 Bradley Rd, Suite 103, Menifee, CA 92586 | 2007-03-06 |
| 1972654804 | Mike Johnson | Specialist | 26916 Cherry Hills Boulevard, Sun City, CA 92586 | 2007-01-16 |
| 1932256849 | Mandana Mirshahzadeh | Nurse Practitioner | 26926 Cherry Hills Blvd Ste B, Menifee, CA 92586 | 2007-01-04 |
| 1184709248 | Technomed Homecare Inc | Durable Medical Equipment & Medical Supplies | 27188 Sun City Blvd, Sun City, CA 92586 | 2006-10-26 |
| 1922193754 | Minh Pham | Dentist | 29950 Haun Rd, Ste 302, Sun City, CA 92586 | 2006-10-04 |
| 1598739203 | Kevin Khuong Nguyen | Family Medicine | 29798 Haun Road, Suite 203, Menifee, CA 92586 | 2006-02-17 |
| 1831199728 | Duane Ray Darnell | Internal Medicine | 27994 Bradley Rd, Ste F, Sun City, CA 92586 | 2005-07-21 |
| 1417445040 | Blair N Kluth | Behavioral Analyst | 27070 Sun City Blvd, Menifee, CA 92586 | 2018-04-30 |
| 1043723869 | New Hope Rx Pharmacy, Inc | Pharmacy | 29798 Haun Rd Ste 100, Menifee, CA 92586 | 2017-11-15 |
| Find all providers in zip 92586 | ||||
| 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 |
|---|---|---|---|---|
| 1245280031 | Timothy P Salmon | Dermatology | 13640 N 99th Ave Ste 300, Sun City, AZ 85351-0001 | 2006-05-11 |
| 1437166840 | Eric Day | Dermatology | 13000 N 103rd Ave, Suite #60, Sun City, AZ 85351-3024 | 2006-08-01 |
| 1053361444 | Faculty Physicians and Surgeons of Llusm | Dermatology | 28125 Bradley Rd, Sun City, CA 92586-2248 | 2006-05-10 |
| 1124008255 | Patricia Ann Carroll-chen | Dermatology | 13640 N 99th Ave, Suite #300, Sun City, AZ 85351-2861 | 2006-01-17 |
| 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 |
| 1669081204 | Lucy Boyadzhian | Dermatology | 7472 Melrose Ave, Los Angeles, CA 90046-7524 | 2020-07-29 |
| 1033730981 | Adrianna Janell Browne, Md, Inc. | Dermatology | 8 Camino Encinas Ste 115, Orinda, CA 94563-3350 | 2020-05-01 |
| 1215564877 | Jasmine Khachatrian | Dermatology | 302 Sierra Woods Dr, Sierra Madre, CA 91024-1015 | 2020-03-24 |
| 1386277499 | Jessica Hsu, M.d.,inc | Dermatology | 1506 Chapman Avenue, Address Line 2, Orange, CA 92866 | 2020-02-17 |
| 1245862101 | Yuval Bibi, A Professional Corporation | Dermatology | 7266 Franklin Ave Apt 321, Los Angeles, CA 90046-8324 | 2020-02-09 |
| 1457982001 | Modesty Joy Isaguirre | Dermatology | 140 S Grand Ave, Glendora, CA 91741-4259 | 2020-02-03 |
| 1790322063 | Mfc Dermatology | Dermatology | 3655 Lomita Blvd Ste 221, Torrance, CA 90505-1918 | 2019-12-05 |
| 1336784206 | Barbara Kinkle Pa Inc., A Physician Assistant Corporation | Dermatology | 24575 Hunt Ave, Corning, CA 96021-8607 | 2019-11-14 |
| 1497399141 | Dermatology Specialists Inc | Dermatology | 4765 Carmel Mountain Rd Ste 201, San Diego, CA 92130-6657 | 2019-11-05 |
| Find all providers with the same taxonomy | ||||
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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.