Dermatology & Laser Center of San Diego

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY & LASER CENTER OF SAN DIEGO

Practice address

344 F St Ste 200
Chula Vista, CA 91910-2646

Phone

(619) 476-1200

Fax

(619) 420-7849

NPI assigned

Jun 17, 2006

Last updated

Oct 31, 2024By 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

Miss Sara Rosales

Title

Insurance Specialist

Phone

(619) 476-1200

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Amy Han, MD

  • Dermatology Physician
  • Chula Vista, CA
  • NPI 1710945365
  Medicare reassignment Care Compare group NPD
• Bryan Leigh, M.D.

  • Therapeutic Radiology Physician
  • San Clemente, CA
  • NPI 1407272669
  Medicare reassignment Care Compare group NPD
• Erick Alfonso Mafong, M.D.

  • MOHS-Micrographic Surgery Physician
  • Chula Vista, CA
  • NPI 1033113725

  Dermatology

  Medicare reassignment Care Compare group NPD
• Cole Bradford Willoughby, M.D.

  • Dermatopathology Physician
  • Chula Vista, CA
  • NPI 1659375301
  Medicare reassignment Care Compare group NPD
• Mark Andrew Willoughby, M.D.

  • Dermatology Physician
  • Chula Vista, CA
  • NPI 1215931993
  Medicare reassignment Care Compare group NPD
• Elizabeth G Abbott, PA-C

  • Physician Assistant
  • San Diego, CA
  • NPI 1437540762
  Medicare reassignment Care Compare group
• Amy Claire Ellsworth, PA-C,MMS

  • Medical Physician Assistant
  • Del Mar, CA
  • NPI 1174711436
  Medicare reassignment Care Compare group
• Evangelia Gryparis, PA-C

  • Physician Assistant
  • Encinitas, CA
  • NPI 1316637770
  Medicare reassignment Care Compare group
• Courtney Kathryn Hopp, PA

  • Physician Assistant
  • San Diego, CA
  • NPI 1083213706
  Medicare reassignment Care Compare group
• Parima Daroui, M.D. PH.D.

  • Radiation Oncology Physician
  • Wildomar, CA
  • NPI 1629283841
  Medicare reassignment NPD
• Stephen W Doggett, M.D.

  • Radiation Oncology Physician
  • Newport Beach, CA
  • NPI 1982675021
  Medicare reassignment NPD
• Nicholas S Muff, MD

  • Specialist
  • Corona, CA
  • NPI 1740372861
  Medicare reassignment NPD

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1457396178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 F ST STE 200",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102646",
            "telephone_number": "619-476-1200",
            "fax_number": "619-420-7849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 F ST STE 200",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102646",
            "telephone_number": "619-476-1200",
            "fax_number": "619-420-7849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & LASER CENTER OF SAN DIEGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "ROSALES",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "INSURANCE SPECIALIST",
        "authorized_official_telephone_number": "619-476-1200",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A69750",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A78399",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "C36597",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A94658",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Check-Up
• Dentists of Chula Vista Hazzaa Yahya Gen PTR (Dental Group Palomar)
• Brian Curtis Denton
• Department of VA
• Marisa Deptala, FNP
• Lecille Marchan Desamparado, MSN, FNP-C
• Annaliz Desantiago Flemate
• Joanne Desiere, COTA/L
• Leticia Desmond
• Genevieve Della Rosa Deutsch, NP

• Dermatology Physician in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.