Golden Coast Dermatology, Skin Cancer And Vein Center Pc
LBN: Golden Coast Dermatology, Skin Cancer And Vein Center Pc
Golden Coast Dermatology, Skin Cancer And Vein Center Pc is an health care organization with primary practice located at 26732 Crown Valley Pkwy Ste 571 , Mission Viejo CA 92691-7305. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, which is considered as the primary health care specialty.
Golden Coast Dermatology, Skin Cancer And Vein Center Pc can be contacted via phone (270) 933-2109, or through Tidwell, William via phone (270) 933-2109.
Contact Information
Primary practice address
26732 Crown Valley Pkwy Ste 571
Mission Viejo CA 92691-7305
Phone: (270) 933-2109
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X |
Profile Details
| NPI number | 1053957456 |
|---|---|
| LBN Legal business name | Golden Coast Dermatology, Skin Cancer And Vein Center Pc |
| DBA Doing business as | |
| Authorized official | Tidwell, William Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 20th, 2019 |
| Last updated | Mar 27th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053957456 | NPPES |
| California | Other | A147575 | CA STATE LICENSE |
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