NPIMap

Organization Active NPI

California Dermatology Institute PC

  • Non-Pharmacy Dispensing Site
  • San Bernardino, CA
National Provider Identifier
1245064013
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
CALIFORNIA DERMATOLOGY INSTITUTE PC
Practice address
980 N D St
San Bernardino, CA 92410-3520
Phone
(805) 298-7034
NPI assigned
Aug 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Authorized official

Name
Navid EzraNPI 1104110071
Title
Owner
Phone
(805) 298-7034

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

980 N D St
San Bernardino, CA 92410-3520

Mailing address

3095 Old Conejo Rd Ste 200
Thousand Oaks, CA 91320-2130
Phone (805) 298-7034

Other names 1

  • California Dermatology Institute Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Navid Ezra MD Inc20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

13132 Studebaker Rd
Ste 7
Norwalk, CA 90650
Phone (562) 380-0540

980 N D St
Sn Bernrdno, CA 92410
Phone (909) 521-7508

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1245064013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 OLD CONEJO RD STE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913202130",
            "telephone_number": "805-298-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 N D ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103520",
            "telephone_number": "805-298-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA DERMATOLOGY INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "EZRA",
        "authorized_official_first_name": "NAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-298-7034"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Dermatology Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.