Organization Active NPI

Redwood Empire Dermatology Inc

Doing business as Dermatology Associates of Sonoma County

  • Specialist
  • Santa Rosa, CA
National Provider Identifier
1154496248
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
REDWOOD EMPIRE DERMATOLOGY INC
Doing business as
Dermatology Associates of Sonoma County
Practice address
990 Sonoma Ave Ste 2
Santa Rosa, CA 95404-4813
Phone
(707) 579-4239
Fax
(707) 579-0459
NPI assigned
Nov 22, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dale Raymond Westrom, M.D., PH.D.NPI 1922032077
Title
President
Phone
(707) 579-4239

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

990 Sonoma Ave Ste 2
Santa Rosa, CA 95404-4813

Mailing address

990 Sonoma Ave Ste 2
Santa Rosa, CA 95404-4813
Phone (707) 579-4239

Other names 1

  • Dermatology Associates of Sonoma County Doing business as

National Provider Directory

National Provider Directory

Locations

4739 Hoen Ave
Santa Rosa, CA 95405
Phone (707) 528-4239

6570 Oakmont Dr
Ste B
Santa Rosa, CA 95409

6575 Oakmont Dr
Santa Rosa, CA 95409
Phone (707) 526-5316

990 Sonoma Ave
Ste 2
Santa Rosa, CA 95404
Phone (707) 527-5155

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154496248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SONOMA AVE STE 2",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044813",
            "telephone_number": "707-579-4239",
            "fax_number": "707-579-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SONOMA AVE STE 2",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044813",
            "telephone_number": "707-579-4239",
            "fax_number": "707-579-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWOOD EMPIRE DERMATOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WESTROM",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-579-4239",
        "authorized_official_credential": "M.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Associates of Sonoma County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.