NPIMap

Organization Active NPI

Dermatology Specialists Inc

  • Dermatology Physician
  • San Diego, CA
National Provider Identifier
1497399141
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY SPECIALISTS INC
Practice address
4765 Carmel Mountain Rd Ste 201
San Diego, CA 92130-6657
Phone
(760) 757-7546
Fax
(760) 828-9138
NPI assigned
Nov 5, 2019
Last updated
Nov 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Authorized official

Name
Missi Heinichen
Title
Admin Assist
Phone
(760) 757-7546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

4765 Carmel Mountain Rd Ste 201
San Diego, CA 92130-6657

Mailing address

3629 Vista Way
Oceanside, CA 92056-4522
Phone (760) 757-7546

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 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.

NPI Registry JSON

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572912000000",
    "number": "1497399141",
    "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": "760-757-7546",
            "fax_number": "760-828-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 CARMEL MOUNTAIN RD STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306657",
            "telephone_number": "760-757-7546",
            "fax_number": "760-828-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-05",
        "last_updated": "2019-11-05",
        "status": "A",
        "authorized_official_last_name": "HEINICHEN",
        "authorized_official_first_name": "MISSI",
        "authorized_official_title_or_position": "ADMIN ASSIST",
        "authorized_official_telephone_number": "760-757-7546"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.