Coastal Valley Dermatology Associates, Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A77492 Issued in CA

Legal business name

COASTAL VALLEY DERMATOLOGY ASSOCIATES, INC

Practice address

757 Pacific St Ste C3
Monterey, CA 93940-2819

Phone

(831) 293-8458

NPI assigned

Dec 13, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Roya Javid, MDNPI 1922189414

Title

President

Phone

(619) 895-2940

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Roya O. Javid, M.D.

  • Dermatology Physician
  • Monterey, CA
  • NPI 1922189414
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1023311172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 PACIFIC ST STE C3",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939402819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 PACIFIC ST STE C3",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939402819",
            "telephone_number": "831-293-8458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL VALLEY DERMATOLOGY ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-13",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "JAVID",
        "authorized_official_first_name": "ROYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-895-2940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A77492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Cline
• Reb Julia Haas Close, M.D.
• CLT, Inc.
• Coastal Home Care Services Inc
• Coastal Home Care Services, Inc.
• Katie Jean Cobb, PA-C
• William Coggin, PA-C
• Larissa Cohen, PHARMD
• Connor O'Neill Cole, PA-C
• Kimberly Coleman

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.