NPIMap

Organization Active NPI

Dermatology Specialists Ins

  • Dermatology Physician
  • Fallbrook, CA
National Provider Identifier
1457541260
Registry record updated Nov 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY SPECIALISTS INS
Practice address
1309 S Mission Rd # a
Fallbrook, CA 92028-4007
Phone
(760) 728-7546
Fax
(760) 723-6208
NPI assigned
Jul 27, 2007
Last updated
Nov 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2008

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

Authorized official

Name
Jane Lisk
Title
Administrator
Phone
(760) 757-7546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X CA Primary

Addresses

Primary practice location

1309 S Mission Rd # a
Fallbrook, CA 92028-4007

Mailing address

3629 Vista Way
Oceanside, CA 92056-4522
Phone (760) 828-9200

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
05D0567097Dermatology Specialists, Inc1309 S Mission Rd, Ste a, Fallbrook, CA 92028Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Dermatology Specialists Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227657600000",
    "number": "1457541260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3629 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564522",
            "telephone_number": "760-828-9200",
            "fax_number": "760-828-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 S MISSION RD # A",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920284007",
            "telephone_number": "760-728-7546",
            "fax_number": "760-723-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY SPECIALISTS INS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2008-11-26",
        "status": "A",
        "authorized_official_last_name": "LISK",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "760-757-7546"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallbrook, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.