Integrated Dermatology and Dermatopathology, Inc.

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

A86806 Issued in CA

Legal business name

INTEGRATED DERMATOLOGY AND DERMATOPATHOLOGY, INC.

Practice address

1525 Superior Ave
Suite 210
Newport Beach, CA 92663-3639

Phone

(949) 722-3555

Fax

(949) 722-3512

NPI assigned

Apr 25, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kay Keeyeul Sung, M.D.NPI 1336278720

Title

President

Phone

(949) 722-3555

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kay Keeyeul Sung, M.D.

  • Procedural Dermatology Physician
  • Newport Beach, CA
  • NPI 1336278720
  Medicare reassignment Care Compare group Authorized official
• Donna Hastert, P.A.-C

  • Physician Assistant
  • Sun City, CA
  • NPI 1932204351
  Medicare reassignment Care Compare group
• Pavitra Parekh, PA-C

  • Physician Assistant
  • Long Beach, CA
  • NPI 1245958743
  Medicare reassignment Care Compare group
• Christine Lopez, NP-C

  • Family Nurse Practitioner
  • Chino, CA
  • NPI 1225425150
  Medicare reassignment NPD
• Robert Mitchell Miller, MD

  • Dermatology Physician
  • Long Beach, CA
  • NPI 1053463760
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1013136357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11902 CANDOR ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036907",
            "telephone_number": "562-714-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 SUPERIOR AVE",
            "address_2": "SUITE 210",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633639",
            "telephone_number": "949-722-3555",
            "fax_number": "949-722-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED DERMATOLOGY AND DERMATOPATHOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "SUNG",
        "authorized_official_first_name": "KAY",
        "authorized_official_middle_name": "KEEYEUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-722-3555",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A86806",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A86806",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A86806",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A86806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Procedural Dermatology Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Procedural Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.