Wilshire Dermatology Medical Group, Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G65423 Issued in CA

Legal business name

WILSHIRE DERMATOLOGY MEDICAL GROUP, INC.

Practice address

5757 Wilshire Blvd
Promenade 2
Los Angeles, CA 90036-5810

Phone

(323) 936-1245

NPI assigned

Mar 24, 2009

Organization subpart

No

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

Authorized official

Name

Harvey Leonard Abrams, M.D.

Title

President/Owner

Phone

(323) 936-1245

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245715200000",
    "number": "1346482239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 WILSHIRE BLVD",
            "address_2": "PROMENADE 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 WILSHIRE BLVD",
            "address_2": "PROMENADE 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365810",
            "telephone_number": "323-936-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSHIRE DERMATOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-06-23",
        "status": "A",
        "authorized_official_last_name": "ABRAMS",
        "authorized_official_first_name": "HARVEY",
        "authorized_official_middle_name": "LEONARD",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "323-936-1245",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G65423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilshire Cardiology Group, a Professional Corporation
• Wilshire Center for Ambulatory Surgery, Inc.
• Wilshire Center for Cosmetic Surgery, a Professional Corporation
• Wilshire Center for Dermatology, a Professional Corporation
• Wilshire Co Medical Group Inc
• Wilshire District Medical Group
• Wilshire Endoscopy Center LLC
• Wilshire Foot and Ankle, Inc.
• Wilshire Health Services Inc
• Wilshire Healthcare Center LLC

• Dermatology Physician in Los Angeles, CA
• Providers in Los Angeles, 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, 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.