David Opai-Tetteh, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A53194 Issued in CA

Practice address

8200 Haven Avenue
Ste101
Rancho Cucamonga, CA 91730

Phone

(909) 649-8031

Fax

(909) 989-6895

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Dermatology

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology Surgical and Medical Group IncGroup PAC ID 5294779898, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Advanced Dermatology Surgical and Medical Group Inc.

  • Dermatology Physician
  • Lakewood, CA
  • NPI 1154407856
  Medicare reassignment Care Compare group NPD
• Botox Fillers Dermatology Inc

  • Clinic/Center
  • Rancho Cucamonga, CA
  • NPI 1689567125
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1427077684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4335 VAN NUYS BLVD",
            "address_2": "SUTIE 315",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033727",
            "telephone_number": "909-649-8031",
            "fax_number": "909-989-6895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 HAVEN AVENUE",
            "address_2": "STE101",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91730",
            "telephone_number": "909-649-8031",
            "fax_number": "909-989-6895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPAI-TETTEH",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A53194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A531940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eseoghene Oniwor I, LMFT
• Lindsey Ann Ontiveros
• Mariah Ontiveros
• Stephanie Marie Ontiveros
• Chanette Onyoyo
• Abigail Ngoclyn Opipaht
• Optimal Wellness Counseling
• Options for Rehab, a Physical Therapy Corporation
• Optum Behavioral Care of California, P.C.
• Optum Behavioral Care of California, P.C.

• Dermatology Physician in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.
• 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.