Dermatology Center of Yuma PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

28963 Issued in AZ

Legal business name

DERMATOLOGY CENTER OF YUMA PLLC

Practice address

2270 S Ridgeview Dr
Ste 302
Yuma, AZ 85364

Phone

(928) 783-0169

NPI assigned

Nov 5, 2007

Organization subpart

Yes

Parent organization

DERMATOLOGY CENTER OF YUMA PLLCAs reported in NPPES

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

Authorized official

Name

Mary Ellen Joan Luchetti, M.D.

Title

President

Phone

(928) 329-4761

Specialties & licenses 2

Addresses

Part of

Dermatology Center of Yuma

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1346420577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 S RIDGEVIEW DR",
            "address_2": "STE 302",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "85364",
            "telephone_number": "928-783-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 S RIDGEVIEW DR",
            "address_2": "STE 302",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "85364",
            "telephone_number": "928-783-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CENTER OF YUMA PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DERMATOLOGY CENTER OF YUMA PLLC",
        "enumeration_date": "2007-11-05",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "LUCHETTI",
        "authorized_official_first_name": "MARY ELLEN",
        "authorized_official_middle_name": "JOAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-329-4761",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "044009",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "28963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.