Walnut Creek Dermatology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

WALNUT CREEK DERMATOLOGY

Practice address

3147 Putnam Blvd
Pleasant Hill, CA 94523-4686

Phone

(925) 391-9439

NPI assigned

Jun 6, 2022

Last updated

Jun 23, 2022By 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. Paige D Radell, MDNPI 1861579021

Title

Doctor

Phone

(925) 391-9439

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Paige Radell, M.D.

  • Dermatology Physician
  • Pleasant Hill, CA
  • NPI 1861579021
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1265161368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3147 PUTNAM BLVD",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945234686",
            "telephone_number": "925-391-9439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3147 PUTNAM BLVD",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945234686",
            "telephone_number": "925-391-9439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT CREEK DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "RADELL",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "925-391-9439",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Wakim
• Walgreen Co (Walgreens #05864)
• Andrea Lynn Walker, M.F.T.
• Katherine Walker
• Robert T Wallace, MSN, RN, CNL, AMB-BC
• Patricia Kim Walsh
• Janet Wan
• Wang & Mo Dental Group, PC
• Allan Yuanshan Wang, DMD, MS
• Rhoda Watson, MA

• Dermatology Physician in Pleasant Hill, CA
• Providers in Pleasant Hill, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.