Forefront Dermatology - Pacific, P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

FOREFRONT DERMATOLOGY - PACIFIC, P.C.

Practice address

8401 Pine Ave Ste 120
Chino, CA 91708-9658

Phone

(909) 789-0937

Fax

(909) 654-3039

NPI assigned

Sep 9, 2024

Organization subpart

No

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

Authorized official

Name

Betsy J Wernli, MD

Title

President

Phone

(920) 482-0671

Specialties & licenses 2

Addresses

Other names 1

• SkinPhysicians & Surgeons, A Forefront Dermatology Practice Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Forefront Dermatology - Pacific, P.C.

  • Dermatology Physician
  • Thousand Oaks, CA
  • NPI 1356535009

  O20031219000212

  Same enrollment
• Forefront Dermatology - Pacific, P.C.

  • Dermatology Physician
  • Upland, CA
  • NPI 1487480448

  O20031219000212

  Same enrollment
• Forefront Dermatology - Pacific, P.C.

  • Dermatology Physician
  • Santa Cruz, CA
  • NPI 1770361875

  O20031219000212

  Same enrollment
• Forefront Dermatology - Pacific, P.C.

  • Dermatology Physician
  • Los Gatos, CA
  • NPI 1861121741

  O20031219000212

  Same enrollment

Tax ID family

Forefront Dermatology - Pacific PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Forefront Dermatology - Pacific, P.C.

  • Dermatology Physician
  • Upland, CA
  • NPI 1487480448
  NPD tax ID

Practitioners 3

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

• Shannon Lambert, MPAS, PA-C

  • Physician Assistant
  • Upland, CA
  • NPI 1548406952
  NPD
• Kristin Mickelson, PA-C

  • Medical Physician Assistant
  • Upland, CA
  • NPI 1982072682
  NPD
• Marie Alexia Stoddard Lyndsey, MD

  • Dermatology Physician
  • Chino, CA
  • NPI 1477096782
  NPD (past)

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1013743079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 PINE AVE STE 120",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917089658",
            "telephone_number": "909-789-0937",
            "fax_number": "909-654-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREFRONT DERMATOLOGY - PACIFIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "WERNLI",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-482-0671",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SkinPhysicians & Surgeons, A Forefront Dermatology Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jesse Flores, D.D.S.
• Fly Now Health Inc
• Daija Monique Foard, MA
• Foot and Ankle Care Team Inc
• Drueciel Orlean Ford, D.D.S.
• Lauren Ashley Foronda, OTR/L
• Arthur T Forrest, D.D.S.
• Nicki Fotiadis, R.PH.
• Fourth Optometric Care of California
• Fred Armogida

• Dermatology Physician in Chino, CA
• Providers in Chino, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.