American Dermatology Centers

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G44761 Issued in CA

Legal business name

AMERICAN DERMATOLOGY CENTERS

Practice address

416 N Bedford Dr
Suite 306
Beverly Hills, CA 90210-4322

Phone

(310) 360-6661

Fax

(310) 360-6669

NPI assigned

Aug 2, 2011

Last updated

Aug 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Glenn Neil Ledesma, M.D

Title

Owner/ Medical Director

Phone

(310) 360-6661

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1154609584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15717",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902091717",
            "telephone_number": "310-360-6661",
            "fax_number": "310-360-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N BEDFORD DR",
            "address_2": "SUITE 306",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104322",
            "telephone_number": "310-360-6661",
            "fax_number": "310-360-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN DERMATOLOGY CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-02",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "LEDESMA",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "OWNER/ MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-360-6661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G44761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.