PACIFIC DERMATOLOGY MEDICAL ASSOCIATES, INC (NPI# 1710025994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710025994 |
| Entity Type | Organization |
| Organization Name | PACIFIC DERMATOLOGY MEDICAL ASSOCIATES, INC |
| Other Organization Name | QUAIL LAKES DERMATOLOGY |
| Practice Address |
4553 Quail Lakes Dr Stockton CA 95207-5257 |
| Practice Telephone | 2099511133 |
| Practice Fax Number | 2099514708 |
| Mailing Telephone | 2099511133 |
| Mailing Fax Number | 2099514708 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. KATHRYN BRIGITTE ROHRER (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 2099511133 |
| Authorized Official Credential | RMA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| QUAIL LAKES DERMATOLOGY | Doing Business As Name - Organization |
| Street Address |
4553 QUAIL LAKES DR |
| City | STOCKTON |
| State | CA |
| Zip Code | 95207-5257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275536872 | Quail Lakes Dermatology Medical Associates, Inc. | Specialist | 4553 Quail Lakes Dr, Stockton, CA 95207-5257 | 2005-05-27 |
| 1487683579 | Walter Stanley Yourchek | Dermatology | 4553 Quail Lakes Dr, Stockton, CA 95207 | 2006-07-01 |
| 1568407013 | Kyle Wayne Herbold | Dermatology | 4553 Quail Lakes Dr, Stockton, CA 95207 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669004438 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 1002 Robinhood Drive, Stockton, CA 95207 | 2020-02-10 |
| 1811533110 | Tanya V Jones | Dental Hygienist | Community Medical Centers, 83 W. March Ln., Stockton, CA 95207 | 2019-11-21 |
| 1053966358 | Ingrid Marcela Saavedra | Behavioral Analyst | 1545 Saint Marks Plaza Ste 9, Stockton, CA 95207 | 2019-08-05 |
| 1497218861 | Turning Point Community Programs | Community/Behavioral Health | 1803 W March Ln Ste C-d, Stockton, CA 95207 | 2019-04-11 |
| 1427510627 | Stockton Sleep Center Inc | Physiological Laboratory | 1545 Saint Marks Plaza, Suite 2, Stockton, CA 95207 | 2019-04-05 |
| 1518436229 | Nicolas Anthony Overby | Occupational Therapist | Windsor Elmhaven Care Cente 6940 Pacific Ave, Stockton, CA 95207 | 2018-11-26 |
| 1912475724 | Ashley Johnson | Behavior Technician | 87 W. March Ln. Suite 6, Stockton, CA 95207 | 2018-11-09 |
| 1124596085 | Korie Cottrell | Behavior Technician | 87 W. March Ln., Suite 6, Stockton, CA 95207 | 2018-11-08 |
| 1760979645 | Maria Esther Rodriguez | Counselor | 2425 W March Ln., Stockton, CA 95207 | 2018-04-17 |
| 1902301161 | Lashray Elliott | Behavior Technician | 2291 W. Mach Lane, Ste C101, Stockton, CA 95207 | 2018-03-28 |
| Find all providers in zip 95207 | ||||
| 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 |
|---|---|---|---|---|
| 1801139068 | Lydia R Kim | Dermatology | 7373 West Ln Ste 355, Stockton, CA 95210-3377 | 2013-04-05 |
| 1376649269 | Gerald N Bock | Dermatology | 1617 St Marks Plaza, C, Stockton, CA 95207 | 2006-09-16 |
| 1063887883 | Sutter Valley Medical Foundation | Dermatology | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2015-12-04 |
| 1578961843 | Stuart I Jacobs Md, A Professional Corporation | Dermatology | 5345 N El Dorado St, Suite 12, Stockton, CA 95207-5872 | 2014-12-18 |
| 1669817011 | Lauren Henderson Lomax | Dermatology | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2013-04-29 |
| 1730475633 | Erin Nicole Fuller | Dermatology | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2011-06-20 |
| 1245462845 | Amanzoopinder Samrao | Dermatology | 7373 West Ln, Stockton, CA 95210-3377 | 2009-08-14 |
| 1255503629 | Roland Hart Md Inc | Dermatology | 3031 W March Ln, Suite 336e, Stockton, CA 95219-6500 | 2008-03-26 |
| 1538280292 | Blanca Esmeralda Ochoa | Dermatology | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2007-04-02 |
| 1023196938 | Moses Elam | Dermatology | 7373 West Ln, Stockton, CA 95210-3377 | 2006-11-01 |
| Find all providers in STOCKTON | ||||
Please comment or provide details below to improve the information on PACIFIC DERMATOLOGY MEDICAL ASSOCIATES, INC.
| 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.