Dermatology & Laser Clinic, Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A69586 Issued in CA

Legal business name

DERMATOLOGY & LASER CLINIC, INC.

Practice address

401 Old Newport Blvd
Suite 102
Newport Beach, CA 92663-4269

Phone

(949) 631-0300

Fax

(949) 631-0302

NPI assigned

Feb 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Pamela Hite, M.D.

Title

Ceo

Phone

(949) 631-0300

Specialties & licenses 3

Addresses

Locations

Practitioners 1

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

• Joseph Fayez Sedrak, M.D.

  • MOHS-Micrographic Surgery Physician
  • Houston, TX
  • NPI 1316966575

  Dermatology

  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1124166400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 OLD NEWPORT BLVD",
            "address_2": "SUITE 102",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634269",
            "telephone_number": "949-631-0300",
            "fax_number": "949-631-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 OLD NEWPORT BLVD",
            "address_2": "SUITE 102",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634269",
            "telephone_number": "949-631-0300",
            "fax_number": "949-631-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & LASER CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "HITE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-631-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A69586",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A69586",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A69586",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Practices of Charles Zahedi
• Dawn Depke, B.A., OBT, NCBTMB
• Glen Depke, BS, ND
• Paul T Depompo, PSY.D.
• Paul Deridder, MD
• Dermclub X Madison Shreeve Inc
• Michael Derose, COTA/L
• Shaunak Subhash Desai, M.D.
• Tanya Sarkisian Desloover
• Melissa Louise Desouza, MD

• Dermatology Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.