Los Altos Dermatology, Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A61091 Issued in CA

Legal business name

LOS ALTOS DERMATOLOGY, INC

Practice address

851 Fremont Ave
Suite 112
Los Altos, CA 94024-5698

Phone

(650) 949-2771

Fax

(650) 949-2388

NPI assigned

Feb 12, 2007

Last updated

Aug 22, 2020By 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

Dr. Siavosh Vossough, MDNPI 1922192111

Title

Ceo Owner

Phone

(650) 949-2771

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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)…

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BECIAA

Practitioners 1

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.

• Siavosh Vossough, M.D.

  • Dermatology Physician
  • Los Altos, CA
  • NPI 1922192111
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457493033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 FREMONT AVE",
            "address_2": "SUITE 112",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245698",
            "telephone_number": "650-949-2771",
            "fax_number": "650-949-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 FREMONT AVE",
            "address_2": "SUITE 112",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245698",
            "telephone_number": "650-949-2771",
            "fax_number": "650-949-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ALTOS DERMATOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VOSSOUGH",
        "authorized_official_first_name": "SIAVOSH",
        "authorized_official_title_or_position": "CEO       OWNER",
        "authorized_official_telephone_number": "650-949-2771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A61091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penny Loeb, MD
• Deborah Carol Loeffler, CMT NCTMB
• Jaclyn Long, MFT
• Daniel Lopez, PHARM.D
• Loren Romley Lac (White Peony Acupuncture)
• Los Altos Eyecare - an Optometry Corporation
• Los Altos Family Smiles
• Los Altos Optometric Group, Inc.
• Los Altos Pharmacy Inc.
• Los Altos Psychiatric Medical Group, Inc.

• Dermatology Physician in Los Altos, CA
• Providers in Los Altos, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.