ADVANCED DERMATOLOGY AND SKIN SURGERY INC (NPI# 1841644804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841644804 |
| Entity Type | Organization |
| Organization Name | ADVANCED DERMATOLOGY AND SKIN SURGERY INC |
| Practice Address |
14830 Los Gatos Blvd Ste 100 Los Gatos CA 95032-2053 |
| Mailing Address |
4155 Moorpark Ave Ste 3 San Jose CA 95117-1714 |
| Practice Telephone | 4083581256 |
| Practice Fax Number | 4083581826 |
| Mailing Telephone | 4082171905 |
| Mailing Fax Number | 4082441318 |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2016-04-15 |
| Authorized Official Name | YI-PIN TSAO (PRACTICE MANAGER) |
| Authorized Official Telephone | 4082171905 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A97430 | CA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821312091 | Advanced Dermatology and Skin Surgery Inc | Dermatology | 4155 Moorpark Ave Ste 3, San Jose, CA 95117-1714 | 2010-03-17 |
| Street Address |
14830 LOS GATOS BLVD STE 100 |
| City | LOS GATOS |
| State | CA |
| Zip Code | 95032-2053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346730157 | Stephanie Chui | Optometrist | 15055 Los Gatos Blvd Ste 300, Los Gatos, CA 95032 | 2018-05-16 |
| 1710474960 | Lisa Richardson | Dietitian, Registered | 15405 Los Gatos Blvd #101, Los Gatos, CA 95032 | 2018-04-13 |
| 1235652934 | Nillofar Tabibi | Pharmacist | 1496 Pollard Road, Los Gatos, CA 95032 | 2017-07-25 |
| 1609397694 | Taylor Dolores Peterson | Marriage & Family Therapist | 15495 Los Gatos Blvd Ste 5, Los Gatos, CA 95032 | 2017-06-29 |
| 1942755418 | Michelle Sunalp | Physician Assistant | 14830 Los Gatos Blvd, Suite 300, Los Gatos, CA 95032 | 2016-08-24 |
| 1295196640 | Mandice Williams | Chiropractor | 236 Oak Meadow Dr, Los Gatos, CA 95032 | 2016-03-14 |
| 1922465020 | Los Gatos Dental Specialists | Dentist | 15075 Los Gatos Blvd, Ste 120, Los Gatos, CA 95032 | 2016-01-20 |
| 1962881813 | Los Gatos Snf, LLC | Skilled Nursing Facility | 16605 Lark Ave., Los Gatos, CA 95032 | 2015-05-26 |
| 1720404312 | Jonathan Davies | Physician Assistant | 15466 Los Gatos Blvd Ste 109-353, Los Gatos, CA 95032 | 2014-03-06 |
| 1588002612 | Jessica Velasco Gutierrez | Licensed Vocational Nurse | 634 W Parr Ave #116, Los Gatos, CA 95032 | 2013-06-11 |
| Find all providers in zip 95032 | ||||
| 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 |
|---|---|---|---|---|
| 1568863439 | James Frederick Edwards | Specialist | 24230 Summit Woods Dr, Los Gatos, CA 95033-9294 | 2014-09-10 |
| 1023430931 | Andrea Hammer | Specialist | 328 Los Gatos Saratoga Rd, Los Gatos, CA 95030-5318 | 2014-01-11 |
| 1326342577 | Regina Helen Negrini | Specialist | 5087 Lone Hill Rd, Los Gatos, CA 95032-2801 | 2011-01-03 |
| 1104013606 | Gary Lynn | Specialist | 15899 Los Gatos Almaden Rd Ste 9, Los Gatos, CA 95032-3739 | 2007-09-27 |
| 1740320498 | Deborah Weidhaas | Specialist | 430 Monterey Ave Ste 2, Los Gatos, CA 95030-5323 | 2007-02-08 |
| 1992841357 | Maureen O. Khoo, Md, Inc. | Specialist | 320 Dardanelli Ln Ste 20b, Los Gatos, CA 95032-1419 | 2007-01-30 |
| 1932283264 | Associated Pathology Medical Group, Inc | Specialist | 105a Cooper Ct, Los Gatos, CA 95032-7604 | 2006-10-24 |
| 1285669762 | Peter Youn | Specialist | 15195 National Ave Ste 206, Los Gatos, CA 95032-2631 | 2006-07-12 |
| 1710919097 | Jack Siegel | Specialist | 121 Griffith Pl, Los Gatos, CA 95030-4211 | 2006-07-07 |
| 1912971045 | Thomas E. Roberts | Specialist | 15405 Los Gatos Blvd, 104, Los Gatos, CA 95032-2500 | 2006-02-15 |
| Find all providers in LOS GATOS | ||||
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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.