Organization Active NPI

Central Coast Dermatology, Inc.

  • Dermatology Physician
  • Monterey, CA
National Provider Identifier
1083863468
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
FNP37805 Issued in CA
Legal business name
CENTRAL COAST DERMATOLOGY, INC.
Practice address
977 Pacific St
Suite B
Monterey, CA 93940-4400
Phone
(831) 648-8000
NPI assigned
Sep 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Authorized official

Name
Richard M Hambley, MDNPI 1053306688
Title
President
Phone
(831) 648-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X FNP37805 CA Primary

Addresses

Primary practice location

977 Pacific St
Suite B
Monterey, CA 93940-4400

Mailing address

977 Pacific St
Suite B
Monterey, CA 93940-4400
Phone (831) 648-8000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1083863468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 PACIFIC ST",
            "address_2": "SUITE B",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939404400",
            "telephone_number": "831-648-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 PACIFIC ST",
            "address_2": "SUITE B",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939404400",
            "telephone_number": "831-648-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COAST DERMATOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-10",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "HAMBLEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-648-8000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "FNP37805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.