F. RICHARD NOODLEMAN MD A PROFESSIONAL CORPORATION (NPI# 1710172994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710172994 |
| Entity Type | Organization |
| Organization Name | F. RICHARD NOODLEMAN MD A PROFESSIONAL CORPORATION |
| Other Organization Name | AGE DEFY DERMATOLOGY AND WELLNESS INCORPORATED |
| Practice Address |
3803 S Bascom Ave Suite 200 Campbell CA 95008-7317 |
| Practice Telephone | 4085590988 |
| Practice Fax Number | 4083694263 |
| Mailing Telephone | 4085590988 |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2007-10-24 |
| Authorized Official Name | DR. FRANK RICHARD NOODLEMAN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4085590988 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
G422290 | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Age Defy Dermatology and Wellness Incorporated | Doing Business As Name - Organization |
| Street Address |
3803 S BASCOM AVE SUITE 200 |
| City | CAMPBELL |
| State | CA |
| Zip Code | 95008-7317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891783148 | Patrick Michael Monahan | Specialist | 3803 S Bascom Ave, Ste 104, Campbell, CA 95008-7317 | 2005-10-11 |
| 1598204943 | Aesthetx | Surgery | 3803 S Bascom Ave, Suite 100, Campbell, CA 95008-7317 | 2017-02-17 |
| 1902252463 | Scott Mcfarland | Orthopaedic Surgery | 3803 S Bascom Ave, Campbell, CA 95008-7317 | 2016-05-13 |
| 1710389838 | Melinda A. Costa, Md, Inc | Surgery | 3803 S Bascom Ave, Suite 100, Campbell, CA 95008-7317 | 2014-09-19 |
| 1790033280 | Kamakshi R Zeidler Md PC | Plastic Surgery | 3803 S Bascom Ave, Suite 100, Campbell, CA 95008-7317 | 2012-08-15 |
| 1124326830 | Rodolfo A Morales M D A Professional Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3803 S Bascom Ave, Suite 102b, Campbell, CA 95008-7317 | 2011-03-03 |
| 1063712743 | Medical Arts Surgery Suite A Medical Corporation | Clinic/Center | 3803 S Bascom Ave, Suite 100, Campbell, CA 95008-7317 | 2010-10-27 |
| 1497062608 | R Laurence Berkowitz Md Inc | Specialist | 3803 S Bascom Ave, Suite 100, Campbell, CA 95008-7317 | 2010-09-09 |
| 1366642225 | Forest Medical Group, Inc. | Specialist | 3803 S Bascom Ave, Suite 210, Campbell, CA 95008-7317 | 2007-07-19 |
| 1316145378 | Jennifer Lee Gunst | Acupuncturist | 3803 S Bascom Ave, Suite 200, Campbell, CA 95008-7317 | 2007-07-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298380 | Kerry Lynn Osteen | Massage Therapist | 3579 S Bascom Ave, Apt 5, Campbell, CA 95008 | 2020-09-02 |
| 1164057550 | Francesca Dalangin | Physical Therapist | 163 E. Hamilton Avenue, Campbell, CA 95008 | 2020-03-06 |
| 1144790767 | Haley Brucato | Behavior Technician | 131 Rose Court Apt. 21, Campbell, CA 95008 | 2018-11-27 |
| 1740765809 | Crystal-xuanthao Nguyen Curammeng | Licensed Vocational Nurse | 251 Llwelyn Ave, Campbell, CA 95008 | 2018-09-25 |
| 1841799236 | Gabrielle Suzanne Buma | Physician Assistant | Uplift Family Services 251 Llewellyn Ave, Campbell, CA 95008 | 2018-02-12 |
| 1093214660 | Toni Lynn Clementi | Marriage & Family Therapist | 116 E. Campbell Ave, Campbell, CA 95008 | 2018-02-08 |
| 1184132573 | My Hanh Thi Nguyen | Behavioral Analyst | 1440 Theresa Avenue, Campbell, CA 95008 | 2018-01-19 |
| 1346770948 | Stephanie Michele Klahold | Pharmacist | 100 North San Tomas Aquino Road, Campbell, CA 95008 | 2017-06-15 |
| 1578095378 | Elina Josephson | Marriage & Family Therapist | 155 E Campbell Ave Ste 117, Campbell, CA 95008 | 2017-03-30 |
| 1912448408 | Suzane Mitchualmacauley | Licensed Vocational Nurse | 251 Llewelyn Ave, Uplift Family Services, Campbell, CA 95008 | 2017-03-16 |
| Find all providers in zip 95008 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053485599 | David R Harris Md A Medical Corporation | Dermatology | 3803 S Bascom Ave, Suite 200, Campbell, CA 95008-7317 | 2006-11-17 |
| 1174697619 | David Robert Harris | Dermatology | 3803 S Bascom Ave, Suite 200, Campbell, CA 95008-7317 | 2006-11-17 |
| 1811061369 | Joe A Gorelick | Dermatology | 3803 S Bascom Ave, Suite 200, Campbell, CA 95008-7317 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578175006 | Lms Medical Services | Dermatology | 1118 N Mccadden Pl, Los Angeles, CA 90038-1213 | 2020-08-17 |
| 1932687241 | Silhouette Medical Group | Dermatology | 101 E Vineyard Ave Ste 107, Livermore, CA 94550-6877 | 2018-07-31 |
| 1780188482 | California Dermatology Physicians | Dermatology | 1902 Fullerton Ave # 102, Corona, CA 92881-3112 | 2018-03-19 |
| 1942709738 | Azadeh Shirazi Md Inc | Dermatology | 7301 Girard Ave Ste 202, La Jolla, CA 92037-5151 | 2018-02-07 |
| 1205342920 | Solano Dermatology Associates Inc | Dermatology | 1700 2nd St Ste 220, Napa, CA 94559-2455 | 2017-12-18 |
| 1831603901 | Laser Medspa, Inc. | Dermatology | 73655 El Paseo Ste N, Palm Desert, CA 92260-4304 | 2017-11-27 |
| 1326427204 | Jennifer Herrmann Md Inc | Dermatology | 421 N Rodeo Dr Ste 7, Beverly Hills, CA 90210-4514 | 2015-05-25 |
| 1235540196 | Microsurgery Goup | Dermatology | 21039 S Figueroa Ave Suite 201, Carson, CA 90745-7042 | 2014-05-14 |
| 1811261183 | Robert Ray Nettles | Dermatology | 8500 Wilshire Blvd Ste 630, Beverly Hills, CA 90211-3139 | 2012-03-02 |
| 1164748737 | Jane Chung | Dermatology | 895 E Fremont Ave Ste 201, Sunnyvale, CA 94087-2973 | 2010-04-08 |
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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.