Dermatology Surgical & Medical Group

LBN: Dermatology Surgical & Medical Group
Dermatology Surgical & Medical Group is an health care organization with primary practice located at 1661 Soquel Dr Building E, Santa Cruz CA 95065. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Dermatology Surgical & Medical Group can be contacted via phone (831) 476-2444, or through Niles, Diana via phone (831) 476-2444.

Contact Information

Primary practice address
1661 Soquel Dr Building E Santa Cruz CA 95065
Fax: (831) 476-3271
Website:
Authorized official contact:
Name: Niles, Diana

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X

Profile Details

NPI number 1962509109
LBN Legal business name Dermatology Surgical & Medical Group
DBA Doing business as
Authorized official Niles, Diana
Entity Organization
Organization subpart 1 No
Enumeration date Sep 20th, 2006
Last updated Jun 26th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962509109 NPPES
California MEDICAID GR0053090

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