NPIMap

Organization Active NPI

California Dermatology Institute PC

  • Non-Pharmacy Dispensing Site
  • San Luis Obispo, CA
National Provider Identifier
1265397574
Registry record updated Dec 18, 2025
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
862 Meinecke Ave Ste 202
San Luis Obispo, CA 93405-3705
Phone
(805) 298-7034
Fax
(805) 298-7139
NPI assigned
Dec 18, 2025
Last updated
Dec 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Authorized official

Name
Navid EzraNPI 1104110071
Title
President
Phone
(805) 222-5803

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

862 Meinecke Ave Ste 202
San Luis Obispo, CA 93405-3705

Mailing address

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

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

3095 Old Conejo Rd
Ste 200
Thousand Oaks, CA 91320
Phone (805) 222-5803

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1766016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766016000000",
    "number": "1265397574",
    "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",
            "fax_number": "805-298-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 MEINECKE AVE STE 202",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934053705",
            "telephone_number": "805-298-7034",
            "fax_number": "805-298-7139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA DERMATOLOGY INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-18",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A",
        "authorized_official_last_name": "EZRA",
        "authorized_official_first_name": "NAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-222-5803"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; 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.