Organization Active NPI

Integrated Dermatology of Mission Viejo, Apmc

  • MOHS-Micrographic Surgery Physician
  • Mission Viejo, CA
National Provider Identifier
1376091553
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
INTEGRATED DERMATOLOGY OF MISSION VIEJO, APMC
Practice address
26691 Plaza Ste 230
Mission Viejo, CA 92691-6300
Phone
(949) 364-2904
Fax
(949) 364-2909
NPI assigned
Sep 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Authorized official

Name
Dr. Frank Q Zhan, MDNPI 1053468934
Title
Ceo
Phone
(949) 364-2904

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0101X Primary

Addresses

Primary practice location

26691 Plaza Ste 230
Mission Viejo, CA 92691-6300

Mailing address

26691 Plaza Ste 230
Mission Viejo, CA 92691-6300
Phone (949) 364-2904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161103002585 CA Part B Supplier - Clinic/Group Practice 1850679341 Receives reassigned benefits from 1 practitioner
Practice locations: Mission Viejo, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2128776Integrated Dermatology26691 Plaza, Ste 230, Mission Viejo, CA 92691ComplianceDec 6, 2027

National Provider Directory

National Provider Directory

Locations

26691 Plaza
Ste 230
Mission Viejo, CA 92691
Phone (949) 364-2904

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": "1473897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1376091553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26691 PLAZA STE 230",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916300",
            "telephone_number": "949-364-2904",
            "fax_number": "949-364-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26691 PLAZA STE 230",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916300",
            "telephone_number": "949-364-2904",
            "fax_number": "949-364-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED DERMATOLOGY OF MISSION VIEJO, APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-15",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "ZHAN",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-364-2904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.