AFFILIATES IN DERMATOLOGY MEDICAL GROUP, INC. (NPI# 1851403521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851403521 |
| Entity Type | Organization |
| Organization Name | AFFILIATES IN DERMATOLOGY MEDICAL GROUP, INC. |
| Other Organization Name | AFFILIATES IN DERMATOLOGY |
| Practice Address |
460 34th Street Oakland CA 94609 |
| Practice Telephone | 5106528091 |
| Practice Fax Number | 5106525156 |
| Mailing Telephone | 5106528091 |
| Mailing Fax Number | 5106525156 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-12-28 |
| Authorized Official Name | DAVID PASLIN (PRESIDENT) |
| Authorized Official Telephone | 5106522926 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207NI0002X |
Dermatology Specialization: Clinical & Laboratory Dermatological Immunology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Affiliates In Dermatology | Doing Business As Name - Organization |
| Street Address |
460 34TH STREET |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902901226 | Leslie Guy Hilger | Dermatology | 460 34th Street, Oakland, CA 94609 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| 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 |
|---|---|---|---|---|
| 1801908579 | Richard S Graham | Dermatology | 460 34th St, Oakland, CA 94609 | 2006-08-31 |
| 1336173822 | Julia Elizabeth Graves | Dermatology | 3300 Webster St Ste 509, Oakland, CA 94609-3149 | 2006-07-10 |
| 1265404719 | Herbert Arthur Holman | Dermatology | 3100 Summit St, Fl 2, Oakland, CA 94609-3412 | 2006-02-07 |
| 1750748562 | Jason F Fung, Md, A Medical Corporation | Dermatology | 3300 Webster St Ste 509, Oakland, CA 94609-3149 | 2016-01-25 |
| 1811354624 | Julia Graves, Md, Inc | Dermatology | 3300 Webster St Ste 509, Oakland, CA 94609-3149 | 2016-01-25 |
| 1427423268 | Lesley Plotke, Md, Inc | Dermatology | 3300 Webster St Ste 509, Oakland, CA 94609-3149 | 2015-12-04 |
| 1629207493 | Lesley Mcmurry Plotke | Dermatology | 3300 Webster St Ste 509, Oakland, CA 94609-3149 | 2009-07-14 |
| 1629270897 | Ani L. Tajirian | Dermatology | 3300 Webster St Ste 509, Oakland, CA 94609-3149 | 2007-06-01 |
| 1972636272 | Ingrid Roseborough | Dermatology | 3300 Webster St, Ste 509, Oakland, CA 94609-3117 | 2007-03-14 |
| 1578609541 | Amy Stevens | Dermatology | 180 Ramapo Valley Rd, Oakland, NJ 07436-2500 | 2007-01-29 |
| Find all providers in OAKLAND | ||||
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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.