Organization Active NPI

Calabasas Medical Spa

  • Dermatology Physician
  • Calabasas, CA
National Provider Identifier
1356785299
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A101945 Issued in CA
Legal business name
CALABASAS MEDICAL SPA
Practice address
23659 Calabasas Rd
Calabasas, CA 91302-1502
Phone
(818) 850-7905
Fax
(818) 225-8866
NPI assigned
Apr 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Authorized official

Name
Jeff Robbins
Title
Administrator
Phone
(818) 850-7905

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X A101945 CA Primary
Preventive Medicine/Occupational Environmental Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0500X G51360 CA

Addresses

Primary practice location

23659 Calabasas Rd
Calabasas, CA 91302-1502

Mailing address

23659 Calabasas Rd
Calabasas, CA 91302-1502
Phone (818) 850-7905

Other identifiers 1

IdentifierTypeStateIssuer
1756802OtherCAINSURANCE

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1356785299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23659 CALABASAS RD",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021502",
            "telephone_number": "818-850-7905",
            "fax_number": "818-225-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23659 CALABASAS RD",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021502",
            "telephone_number": "818-850-7905",
            "fax_number": "818-225-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALABASAS MEDICAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "ROBBINS",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-850-7905"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A101945",
            "primary": true
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "G51360",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE",
            "identifier": "1756802",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.