Medical Dermatology & Cosmetic Clinic of Northern California

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MEDICAL DERMATOLOGY & COSMETIC CLINIC OF NORTHERN CALIFORNIA

Practice address

650 University Ave Ste 200
Sacramento, CA 95825

Phone

(916) 771-7700

NPI assigned

Dec 15, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Pantea Hashemi, MDNPI 1902123383

Title

Founder

Phone

(916) 571-5200

Specialties & licenses 3

Addresses

Other names 1

• University Skin Institute Doing business as

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 6

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

• Pantea Hashemi, M.D.

  • Dermatology Physician
  • Sacramento, CA
  • NPI 1902123383
  Medicare reassignment Care Compare group NPD Authorized official
• Oma N Agbai, MD

  • Dermatology Physician
  • Sacramento, CA
  • NPI 1114246154
  Medicare reassignment Care Compare group NPD
• Ewan Ho, FNP-BC

  • Family Nurse Practitioner
  • Sacramento, CA
  • NPI 1629836663
  NPD
• Esmeralda Bako, PA

  • Physician Assistant
  • Sacramento, CA
  • NPI 1770372039
  NPD (past)
• Louis Pham, FNP-C

  • Family Nurse Practitioner
  • Upland, CA
  • NPI 1235897281
  NPD (past)
• Pardeep Sandhu, FNP

  • Family Nurse Practitioner
  • Stockton, CA
  • NPI 1366108698
  NPD (past)

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1083120992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 UNIVERSITY AVE STE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 UNIVERSITY AVE STE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95825",
            "telephone_number": "916-771-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 University Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958256726",
            "country_code": "US",
            "telephone_number": "916-771-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL DERMATOLOGY & COSMETIC CLINIC OF NORTHERN CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-15",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "HASHEMI",
        "authorized_official_first_name": "PANTEA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "916-571-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Skin Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medgo Transit LLC
• Medi-Stop, Inc.
• Lesley Mediana
• Madalyn Mediano
• Medic Health LLC
• Medical Health Providers
• Medical Insights Diagnostic Centers Concord Professional Corporation
• Medical Line Services LLC
• Medical Support Los Angeles a Medical Corporation
• Medical Transport 4 U Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.