Oasis Dermatology, Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

OASIS DERMATOLOGY, INC

Practice address

12565 Hesperia Rd Ste 3
Victorville, CA 92395-8318

Phone

(760) 780-0003

Fax

(760) 766-1908

NPI assigned

Oct 3, 2023

Organization subpart

No

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

Authorized official

Name

Liza Gill, MDNPI 1508240458

Title

President

Phone

(760) 780-0003

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 3

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

• Liza Gill, M.D.

  • Dermatology Physician
  • Victorville, CA
  • NPI 1508240458
  Medicare reassignment Care Compare group NPD Authorized official
• Rian Nina Manuel Jaffer, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Loma Linda, CA
  • NPI 1841407798
  Medicare reassignment Care Compare group
• Zondree Arquetta Scott, PA-C

  • Physician Assistant
  • Victorville, CA
  • NPI 1386913531
  Medicare reassignment

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707004800000",
    "number": "1043090582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12565 HESPERIA RD STE 3",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958318",
            "telephone_number": "760-780-0003",
            "fax_number": "760-766-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12565 HESPERIA RD STE 3",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958318",
            "telephone_number": "760-780-0003",
            "fax_number": "760-766-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OASIS DERMATOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2024-02-04",
        "certification_date": "2024-02-04",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "LIZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-780-0003",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Renita O'Connor
• Chere Ann O'Grady, P.A-C
• Karen Lynne O'Rear II
• Kevin O'Rourke
• Oak & Vale Care Inc.
• Joseph S Obadahun, LICENSEE
• Mayra Ocegueda Salazar
• Abigail Ochoa
• Rito Ochoa
• Ninos M Oda, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2024; 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.