New Image Creations, Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A53194 Issued in CA

Legal business name

NEW IMAGE CREATIONS, INC.

Practice address

14624 Sherman Way
Suite 409
Van Nuys, CA 91405-2241

Phone

(818) 782-8300

Fax

(818) 782-8301

NPI assigned

Feb 3, 2009

Organization subpart

No

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

Authorized official

Name

David Opai-Tetteh, M.D.

Title

Ceo

Phone

(818) 782-8300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256688000000",
    "number": "1114165875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4335 VAN NUYS BLVD",
            "address_2": "SUITE 315",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033727",
            "telephone_number": "818-782-8300",
            "fax_number": "818-782-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14624 SHERMAN WAY",
            "address_2": "SUITE 409",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914052241",
            "telephone_number": "818-782-8300",
            "fax_number": "818-782-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW IMAGE CREATIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-03",
        "last_updated": "2009-10-28",
        "status": "A",
        "authorized_official_last_name": "OPAI-TETTEH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-782-8300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A53194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; 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.