Spectrum Dermatology Medical Assocs Corp.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

A46142 Issued in CA

Legal business name

SPECTRUM DERMATOLOGY MEDICAL ASSOCS CORP.

Doing business as

Spectrum Dermatology and Associates

Practice address

665 Munras Ave
Suite 200
Monterey, CA 93940-3134

Phone

(831) 372-6900

Fax

(831) 372-0266

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jacob S. Lo, M.D.

Title

President

Phone

(831) 372-6900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SPECTRUM DERMATOLOGY AND ASSOCIATES Doing business as

Locations

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242950400000",
    "number": "1194750661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 MUNRAS AVE",
            "address_2": "SUITE 200",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939403134",
            "telephone_number": "831-372-6900",
            "fax_number": "831-372-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 MUNRAS AVE",
            "address_2": "SUITE 200",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939403134",
            "telephone_number": "831-372-6900",
            "fax_number": "831-372-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM DERMATOLOGY MEDICAL ASSOCS CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-05-22",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-372-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A46142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1831131069",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPECTRUM DERMATOLOGY AND ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Arslan Soyarslan, DDS
• Kate Spacher, LCSW
• Nancy Annette Spangler
• Special Kids Crusade
• Special Kids Crusade
• David Dale Spilker, M.D.
• Gregory Scott Spowart, M.D.
• Hannah Zeta Sprotte
• Shruthi Srinivasan, DDS
• Melissa Maria Stach

• MOHS-Micrographic Surgery Physician in Monterey, CA
• Providers in Monterey, CA by specialty
• MOHS-Micrographic Surgery Physician in California

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