NPIMap

Organization Active NPI

Advanced Skin Care and Dermatology Physicians of Northern California,

  • Dermatology Physician
  • Sebastopol, CA
National Provider Identifier
1346544525
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ADVANCED SKIN CARE AND DERMATOLOGY PHYSICIANS OF NORTHERN CALIFORNIA,
Practice address
7064 Corline CT
Suite C
Sebastopol, CA 95472-4528
Phone
(707) 829-5778
Fax
(707) 829-7629
NPI assigned
Jan 3, 2011
Last updated
Jan 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Authorized official

Name
Dr. Cynthia S Bailey, M.D.NPI 1558304840
Title
President
Phone
(707) 829-5778

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

7064 Corline CT
Suite C
Sebastopol, CA 95472-4528

Mailing address

7064 Corline CT
Suite C
Sebastopol, CA 95472-4528
Phone (707) 829-5778

National Provider Directory

National Provider Directory

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": "1294012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294012800000",
    "number": "1346544525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7064 CORLINE CT",
            "address_2": "SUITE C",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724528",
            "telephone_number": "707-829-5778",
            "fax_number": "707-829-7629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7064 CORLINE CT",
            "address_2": "SUITE C",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724528",
            "telephone_number": "707-829-5778",
            "fax_number": "707-829-7629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SKIN CARE AND DERMATOLOGY PHYSICIANS OF NORTHERN CALIFORNIA,",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-03",
        "last_updated": "2011-01-03",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-829-5778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.