DR. JEFFREY THOMAS BORTZ (NPI# 1710191382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710191382 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY THOMAS BORTZ |
| Credential | M.D. |
| Practice Address |
355 Lennon Ln Suite 355 Walnut Creek CA 94598-2418 |
| Practice Telephone | 9259327704 |
| Mailing Telephone | 9259327704 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2013-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | A487440 | CA | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
A487440 | CA | Allopathic & Osteopathic Physicians |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
A487440 | CA | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
A487440 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
355 LENNON LN SUITE 355 |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94598-2418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265427975 | Kenneth C Hsiao | Specialist | 355 Lennon Ln, Suite 205, Walnut Creek, CA 94598-2418 | 2005-09-19 |
| 1013277219 | Moushumi Sen | Social Worker | 355 Lennon Ln, Suite 150, Walnut Creek, CA 94598-2475 | 2012-05-22 |
| 1972822989 | Tiffany Hsu Ham | Dentist | 355 Lennon Ln, #215, Walnut Creek, CA 94598-2475 | 2010-06-01 |
| 1720122831 | Vitas Healthcare Corporation of California | Hospice Care, Community Based | 355 Lennon Ln, Suite 150, Walnut Creek, CA 94598-2475 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639716608 | Tasnim Diaf Moulton | Counselor | 2730 Shadelands Drive, Walnut Creek, CA 94598 | 2019-12-09 |
| 1790255370 | Harmony Grace Davis | Behavior Technician | 2730 Shadelands Drive Bldg 10, Walnut Creek, CA 94598 | 2018-11-27 |
| 1922583772 | Melissa Anne Mcgovern | Behavioral Analyst | 2370 Shadelands Drive, Bldg 10, Walnut Creek, CA 94598 | 2018-09-27 |
| 1184108367 | Brett Heflin Woodrufff | Behavior Technician | 2730 Shandeland Dr. Building 10, Walnut Creek, CA 94598 | 2018-09-24 |
| 1710411640 | Mandy Wei | Pharmacist | 2880 Shadeland Dr, Suite 201, Walnut Creek, CA 94598 | 2017-04-18 |
| 1437683497 | Hayley Miller | Student in an Organized Health Care Education/Training Program | 2204 Lomond Lane, Walnut Creek, CA 94598 | 2017-04-17 |
| 1043601594 | Marlene Perez Riedel | Nurse Practitioner | 450 North Wiget Lane, Walnut Creek, CA 94598 | 2015-02-05 |
| 1922418904 | Dante Michael Sorrentino | Ophthalmology | Kaiser Permanente Park Shadelands Medical Offices, 320 Lennon Lane, Walnut Creek, CA 94598 | 2014-04-30 |
| 1194156505 | Robert Harrison Hubbell | Obstetrics & Gynecology | 838 Stonehaven Dr, Walnut Creek, CA 94598 | 2013-12-11 |
| 1174954192 | Paul Mead | Orthopaedic Surgery | 2405 Shadelands Dr Ste 300, Walnut Creek, CA 94598 | 2013-12-01 |
| Find all providers in zip 94598 | ||||
| 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/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700860871 | Golden State Dermatology Associates, Inc. | Dermatology | 355 Lennon Ln Ste 255, Walnut Creek, CA 94598-2496 | 2005-12-02 |
| 1407934599 | Kathleen M. Ting | Dermatology | 320 Lennon Ln, Walnut Creek, CA 94598-2419 | 2006-11-02 |
| 1518077411 | Heather Marie Nudo | Dermatology | 110 Tampico, Suite 200, Walnut Creek, CA 94598-2998 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 | WALNUT CREEK |
| Zip Code | 94598 |
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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.