Individual provider Active NPI

Demijon Lingad Dicen

  • Physician Assistant
  • Beverly Hills, CA
National Provider Identifier
1528726429
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60429 Issued in CA
Practice address
215 S la Cienega Blvd Ste 207
Beverly Hills, CA 90211-3322
Phone
(310) 272-4395
NPI assigned
Dec 8, 2021
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 60429 CA Primary

Addresses

Primary practice location

215 S la Cienega Blvd Ste 207
Beverly Hills, CA 90211-3322

Mailing address

215 S la Cienega Blvd Ste 207
Beverly Hills, CA 90211-3322
Phone (310) 272-4395

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221214000844 CA Practitioner - Physician Assistant 7517336597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbor Wound Care P CGroup PAC ID 0042704504, 29 clinicians

Practice addresses (Care Compare)

1424 Hummingbird Way
Banning, CA 92220-7206
Phone (626) 250-4912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Anti Aging Medical Group, Inc. CurrentSince Dec 12, 2021 Accepting new patients
Harbor Wound Care P.C. CurrentSince Dec 1, 2025 Accepting new patients
May MD Inc. CurrentSince Nov 1, 2025 Accepting new patients
Empire Wound Care CurrentSince Dec 6, 2025 Accepting new patients
Dermking Institute PastSince Dec 12, 2021 Accepting new patients

Locations

215 S La Cienega Blvd
Ste 207
Beverly Hills, CA 90211
Phone (310) 272-4395

10736 Jefferson Blvd
Los Angeles, CA 90230
Phone (310) 313-0999

136 E Walnut Ave
Monrovia, CA 91016
Phone (323) 803-3284

1651 Response Rd
Ste 350
Sacramento, CA 95815
Phone (818) 450-1188

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1528726429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S LA CIENEGA BLVD STE 207",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113322",
            "telephone_number": "310-272-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S LA CIENEGA BLVD STE 207",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113322",
            "telephone_number": "310-272-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICEN",
        "first_name": "DEMIJON",
        "middle_name": "LINGAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.