John Keith Nylund, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

CO34111 Issued in CA

Practice address

14650 Aviation Blvd
Suite 235
Hawthorne, CA 90250-6656

Phone

(310) 643-9333

Fax

(310) 643-9337

NPI assigned

Apr 3, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wu Enterprise Inc.

  • Procedural Dermatology Physician
  • Long Beach, CA
  • NPI 1881352581

  Single Specialty

  Medicare reassignment NPD
• Douglas K Ulmer MD, a Medical Corporation

  • Non-Pharmacy Dispensing Site
  • Long Beach, CA
  • NPI 1841233624

  Single Specialty

  NPD
• James Wu MD Inc

  • Dermatology Physician
  • Hawthorne, CA
  • NPI 1134785785

  Single Specialty

  NPD

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1407029069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14650 AVIATION BLVD",
            "address_2": "SUITE 235",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902506668",
            "telephone_number": "310-643-9333",
            "fax_number": "310-643-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 AVIATION BLVD",
            "address_2": "SUITE 235",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902506656",
            "telephone_number": "310-643-9333",
            "fax_number": "310-643-9337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYLUND",
        "first_name": "JOHN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "CO34111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSWORD FOR PALMETTO",
            "identifier": "WWH7CB",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LISCECE",
            "identifier": "CO34111",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPTAN #",
            "identifier": "W9243",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Farshad Joseph Nosratian, MD
• Inocencia Dario Nuccio, NP
• Michael Nunberg, PHARMD
• Bernard Ngonadi Nwaogwugwu, LVN
• Ifeoma Stella Nweke
• Deysi Barrientos O'Connell
• Ololade Olamide Obafemi, NP
• Obiageli Ifeoma Obah, NP
• Karla M Ocampo I
• Ocean View Specialists

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.