MAGNOLIA DERMATOLOGY INC (NPI# 1972990653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972990653 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA DERMATOLOGY INC |
| Practice Address |
770 Magnolia Ave Suite 2g Corona CA 92879-3120 |
| Practice Telephone | 9517346500 |
| Practice Fax Number | 9517346555 |
| Mailing Telephone | 9517346500 |
| Mailing Fax Number | 9517346555 |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2015-04-21 |
| Authorized Official Name | DR. BABAK ROSHDIEH (OWNER) |
| Authorized Official Telephone | 9517346500 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | A76333 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
770 MAGNOLIA AVE SUITE 2G |
| City | CORONA |
| State | CA |
| Zip Code | 92879-3120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396730560 | Rupal B Shah | Family Medicine | 770 Magnolia Ave, Suite 1k, Corona, CA 92879-3120 | 2005-09-14 |
| 1013314145 | Morton P. Israel, M.d. | Eyewear Supplier (Equipment, not the service) | 770 Magnolia Ave, Suite 2d, Corona, CA 92879-3120 | 2014-12-04 |
| 1982043139 | Monique Cerissa Mariscal | Physician Assistant | 770 Magnolia Ave, 2a, Corona, CA 92879-3120 | 2013-06-20 |
| 1225383763 | Orange Psychiatric Medical Group, Inc | Counselor | 770 Magnolia Ave, Suite 1f, Corona, CA 92879-3121 | 2012-07-20 |
| 1275852956 | Brenda C. White | Nurse Practitioner | 770 Magnolia Ave, Suite 2a, Corona, CA 92879-3120 | 2010-05-20 |
| 1346578184 | Tahja R Mcdowell | Psychologist | 770 Magnolia Ave, 1f, Corona, CA 92879-3120 | 2009-12-04 |
| 1902046097 | Dr.bhagat & Uppal, A.p.d.c. | Dentist | 770 Magnolia Ave, Suite 1-j, Corona, CA 92879-3120 | 2009-03-02 |
| 1164692596 | Andrew Allen Harper | Pharmacist | 770 Magnolia Ave, Suite 1g, Corona, CA 92879-3120 | 2008-02-29 |
| 1932257276 | Inland Psychiatric Medical Group, Inc. | Psychologist | 770 Magnolia Ave, Suite 1f, Corona, CA 92879-3120 | 2007-01-05 |
| 1548325145 | Trupath Laboratories, Inc. | Clinical Medical Laboratory | 770 Magnolia Ave, Suite 2g, Corona, CA 92879-3120 | 2006-12-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475722 | Tahmea Henderson | Behavior Technician | 225 Rincon St. #219, Corona, CA 92879 | 2020-10-20 |
| 1669084828 | Kimberly O Harris | Behavioral Analyst | 225 E. Rincon St., Suite 219, Corona, CA 92879 | 2020-08-19 |
| 1962014381 | Mario Javier Herrera | Nurse Practitioner | 2130 High Pointe Dr, Apt 108, Corona, CA 92879 | 2020-08-18 |
| 1841659117 | Sleep & Cpap Center Inc | Clinical Medical Laboratory | 800 Magnolia Avenue, Suite 101, Corona, CA 92879 | 2016-02-16 |
| 1497151203 | Rafik Riad | Dentist | 817 Villa Montes Cir., Corona, CA 92879 | 2014-11-06 |
| 1326441551 | Ying Zhang Howe | Acupuncturist | 720 Magnolia Ave. #b3, Corona, CA 92879 | 2014-10-02 |
| 1164823233 | Piyush Sakhareliya | Pharmacist | 2230 Treemont Pl, Apt#207, Corona, CA 92879 | 2014-09-09 |
| 1053711739 | Brandice Medical Associates Inc | Clinical Medical Laboratory | 13575 Jasper Loop, Corona, CA 92879 | 2014-08-29 |
| 1982956058 | Nja Therapy Services, Inc. | Day Training, Developmentally Disabled Services | 1655 E 6th St Suite 204, Corona, CA 92879 | 2012-10-12 |
| 1356616064 | Corona Surgical LLC | Clinic/Center | 2370 Anselmo Drive, Corona, CA 92879 | 2012-03-13 |
| Find all providers in zip 92879 | ||||
| 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 |
|---|---|---|---|---|
| 1275589723 | Babak Roshdieh | Dermatology | 770 Magnolia Ave, Suite 2g, Corona, CA 92879-3120 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275144024 | Lumins Aesthetic and Wellness, Inc | Dermatology | 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 | 2020-08-14 |
| 1669081204 | Lucy Boyadzhian | Dermatology | 7472 Melrose Ave, Los Angeles, CA 90046-7524 | 2020-07-29 |
| 1033730981 | Adrianna Janell Browne, Md, Inc. | Dermatology | 8 Camino Encinas Ste 115, Orinda, CA 94563-3350 | 2020-05-01 |
| 1215564877 | Jasmine Khachatrian | Dermatology | 302 Sierra Woods Dr, Sierra Madre, CA 91024-1015 | 2020-03-24 |
| 1386277499 | Jessica Hsu, M.d.,inc | Dermatology | 1506 Chapman Avenue, Address Line 2, Orange, CA 92866 | 2020-02-17 |
| 1245862101 | Yuval Bibi, A Professional Corporation | Dermatology | 7266 Franklin Ave Apt 321, Los Angeles, CA 90046-8324 | 2020-02-09 |
| 1457982001 | Modesty Joy Isaguirre | Dermatology | 140 S Grand Ave, Glendora, CA 91741-4259 | 2020-02-03 |
| 1790322063 | Mfc Dermatology | Dermatology | 3655 Lomita Blvd Ste 221, Torrance, CA 90505-1918 | 2019-12-05 |
| 1336784206 | Barbara Kinkle Pa Inc., A Physician Assistant Corporation | Dermatology | 24575 Hunt Ave, Corning, CA 96021-8607 | 2019-11-14 |
| 1497399141 | Dermatology Specialists Inc | Dermatology | 4765 Carmel Mountain Rd Ste 201, San Diego, CA 92130-6657 | 2019-11-05 |
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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.