Palmdale Dermatology and Skin Cancer PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PALMDALE DERMATOLOGY AND SKIN CANCER PC

Practice address

631 W Avenue Q
Suite B
Palmdale, CA 93551-3892

Phone

(661) 947-9000

Fax

(661) 266-8751

NPI assigned

Jun 29, 2012

Organization subpart

No

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

Authorized official

Name

Daniel Taheri, MD

Title

President

Phone

(661) 947-9000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1144584574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496084",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960496084",
            "telephone_number": "661-947-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 W AVENUE Q",
            "address_2": "SUITE B",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513892",
            "telephone_number": "661-947-9000",
            "fax_number": "661-266-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMDALE DERMATOLOGY AND SKIN CANCER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-29",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "TAHERI",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-947-9000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP",
            "identifier": "FNP42964",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidy Palma
• Palmdale Ambulatory Surgery Center
• Palmdale Ambulatory Surgery Center LLC
• Palmdale Anesthesia, Inc
• Palmdale Congregate Living, Inc.
• Palmdale Intensivist Inc
• Palmdale Medical Clinic Inc
• Palmdale Medical Group
• Palmdale Medical Pharmacy Inc
• Palmdale Mental Health Center

• All providers in Palmdale, CA
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.