Solano Dermatology Associates Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

019731 Issued in CA

Legal business name

SOLANO DERMATOLOGY ASSOCIATES INC

Practice address

600 Nut Tree Rd
Suite 260
Vacaville, CA 95687-4669

Phone

(707) 452-7222

Fax

(707) 452-8507

NPI assigned

Apr 27, 2007

Last updated

Apr 12, 2012By 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

Ms. Sandie Fowler

Title

Credentialing Specialist

Phone

(707) 556-5991

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Solano Dermatology Associates Inc

  • Dermatology Physician
  • Vallejo, CA
  • NPI 1922052729

  O20060928000473

  Same enrollment

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 18

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.

• Erica R Aronson, M.D.

  • Dermatology Physician
  • Napa, CA
  • NPI 1033431549
  NPD
• Karl Reinhard Beutner, M.D. PH.D

  • Dermatology Physician
  • Fairfield, CA
  • NPI 1649217936
  NPD
• Carey L Cano, PA-C

  • Medical Physician Assistant
  • Vallejo, CA
  • NPI 1114986809
  NPD
• Jennifer M Fu, M.D.

  • Dermatology Physician
  • El Cerrito, CA
  • NPI 1619000791
  NPD
• Lauren Elizabeth Gebauer, M.D.

  • MOHS-Micrographic Surgery Physician
  • Napa, CA
  • NPI 1386960961

  Dermatology

  NPD
• John Kevin Geisse, M.D.

  • MOHS-Micrographic Surgery Physician
  • Vallejo, CA
  • NPI 1275571028

  Dermatology

  NPD
• Kyle Joseph Goleno, PA-C

  • Surgical Physician Assistant
  • Vallejo, CA
  • NPI 1083667851
  NPD
• Vera Lee, NP-C

  • Family Nurse Practitioner
  • San Jose, CA
  • NPI 1215437223
  NPD
• Hanna Marie Massee, PA-C

  • Physician Assistant
  • Fairfield, CA
  • NPI 1487298667
  NPD
• Serena Mraz, M.D.

  • Dermatology Physician
  • Vallejo, CA
  • NPI 1518911395
  NPD
• Margaret Malig Nonato, PA-C

  • Medical Physician Assistant
  • Vallejo, CA
  • NPI 1013961572
  NPD
• Lauren M Nystrom, PA-C

  • Medical Physician Assistant
  • Napa, CA
  • NPI 1336398304
  NPD

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1356561682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 SACRAMENTO ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945902929",
            "telephone_number": "707-643-5785",
            "fax_number": "707-643-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NUT TREE RD",
            "address_2": "SUITE 260",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956874669",
            "telephone_number": "707-452-7222",
            "fax_number": "707-452-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLANO DERMATOLOGY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "SANDIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "707-556-5991",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "019731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Solano Alpha Crisis Pregnancy Center (Alpha Pregnancy Resource Center)
• Solano Care, Inc
• Solano Care, LLC
• Solano Connect, LLC
• Solano Connect, LLC
• Solano Plastic Surgery, Inc
• Solano Regional Medical Grou
• Solano Regional Medical Group Inc
• Solano Sports Physical Therapy & Training, Inc. (Solano Sports Physical Therapy)
• Solano Sports Physical Therapy Inc

• Dermatology Physician in Vacaville, CA
• Providers in Vacaville, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.